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When beginning herbal products, the nurse understands that the best way to identify allergic or other adverse reactions is to have the client:
- A. Take less than the recommended dose initially.
- B. Never take with prescription medications.
- C. Check with a reputable pharmacist.
- D. Use only one herbal preparation at a time.
- G. D
Correct Answer: Lower doses may not reveal reactions. Avoiding prescriptions isn't always necessary. Pharmacist consultation is good but not best for identification. One product at a time isolates reactions.
Rationale: The correct answer is D: Use only one herbal preparation at a time. By using only one herbal preparation at a time, the nurse can accurately identify any allergic or adverse reactions that may occur. This approach allows for clear isolation of the effects of each herb, making it easier to pinpoint the source of any reactions. Taking lower doses (choice A) may not always reveal reactions as some individuals may still have adverse effects. Never taking herbal products with prescription medications (choice B) is overly restrictive and not always necessary. Checking with a reputable pharmacist (choice C) is a good practice for general information but may not be the most effective way to identify specific reactions.
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The patient with tuberculosis is now on isoniazid (INH). Which laboratory test should the nurse monitor?
- A. BUN
- B. PT and PTT
- C. Liver enzymes (LFTs)
- D. CBC
- G. C
Correct Answer: BUN, PT/PTT, and CBC aren't specific to INH. Liver enzymes are monitored due to INH's hepatotoxicity risk.
Rationale: The correct answer is C. The nurse should monitor liver enzymes (LFTs) in a patient on isoniazid (INH) due to the risk of hepatotoxicity associated with this medication. 1. Isoniazid is known to cause liver damage in some patients. 2. Monitoring liver enzymes can help detect any liver dysfunction early. 3. LFTs include tests such as ALT, AST, and bilirubin, which can indicate liver damage. 4. Regular monitoring of LFTs is essential to ensure the safe use of INH. Incorrect choices: A. BUN is not specific to INH. B. PT and PTT are not directly related to INH use. D. CBC is not specifically required for monitoring INH therapy.
A nurse is assisting with the care of four clients who have peptic ulcer disease. The nurse should identify that misoprostol (Cytotec) is contraindicated for which of the following clients?
- A. A client who is pregnant.
- B. A client who has osteoarthritis.
- C. A client who has a urinary tract infection.
- D. A client who has a kidney stone.
- G. A
Correct Answer: Misoprostol can induce labor or miscarriage, making it contraindicated in pregnancy. It's safe for osteoarthritis, UTIs, and kidney stones as it doesn't interact adversely with these conditions.
Rationale: Correct Answer: A. A client who is pregnant.
Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor or miscarriage due to its uterotonic effects. This medication is used to prevent gastric ulcers in patients taking NSAIDs, not for conditions like osteoarthritis, urinary tract infection, or kidney stones. Thus, it is important to avoid its use in pregnant individuals to prevent harm to the fetus.
Summary of Other Choices:
B: Misoprostol is safe for a client with osteoarthritis as it does not pose any specific risks or contraindications for this condition.
C: Misoprostol does not interact adversely with urinary tract infections, so it is safe for a client with this condition.
D: Misoprostol does not have any contraindications for kidney stones; therefore, it is safe for a client with this condition.
Which of the following is a violation of safe practice when administering insulin?
- A. Administering ordered insulin subcutaneously.
- B. Using an insulin syringe to administer the insulin dose.
- C. Drawing up the ordered dose in a 3 mL syringe.
- D. Verifying the drawn-up insulin dose with another nurse.
- G. C
Correct Answer: Subcutaneous administration and insulin syringes are correct. A 3 mL syringe lacks insulin unit markings, risking errors. Verification with another nurse is a safety practice.
Rationale: The correct answer is C: Drawing up the ordered dose in a 3 mL syringe is a violation of safe practice when administering insulin. Here's a detailed rationale:
1. Administering ordered insulin subcutaneously (Choice A) is correct as insulin is typically administered subcutaneously.
2. Using an insulin syringe to administer the insulin dose (Choice B) is correct, as insulin syringes are specifically designed for accurate insulin dosing.
3. Drawing up the ordered dose in a 3 mL syringe (Choice C) is incorrect because 3 mL syringes lack insulin unit markings, increasing the risk of dosing errors.
4. Verifying the drawn-up insulin dose with another nurse (Choice D) is a safety practice and is correct to ensure accuracy and prevent errors.
In summary, choice C is incorrect because using a 3 mL syringe can lead to dosing errors, while the other choices are safe practices in administering insulin.
Complete the following statement: “Drugs used for the treatment of depression and a range of anxiety disorders including panic, social phobia, and post-traumatic stress disorder are known as…â€
- A. Barbiturates
- B. Rebound insomnia
- C. Antidepressants
- D. Anxiolytics
- G. C
Correct Answer: Barbiturates are sedatives. Rebound insomnia isn't a drug. Antidepressants treat depression and anxiety disorders. Anxiolytics focus on anxiety.
Rationale: The correct answer is C: Antidepressants. Antidepressants are drugs specifically designed to treat depression and various anxiety disorders, including panic, social phobia, and post-traumatic stress disorder. They work by balancing neurotransmitters in the brain to improve mood and reduce symptoms of anxiety. Barbiturates (A) are sedatives, not typically used for treating anxiety or depression. Rebound insomnia (B) is a phenomenon where insomnia worsens after discontinuing sleep medications, not a class of drugs. Anxiolytics (D) are drugs that specifically target anxiety symptoms, but they do not usually address depression. Therefore, the correct choice is C as it accurately describes the drugs used for treating depression and a range of anxiety disorders.
A client taking an MAOI should be instructed to avoid which item?
- A. Large amounts of water
- B. A diet that is high in salt
- C. A diet that is high in fat
- D. Foods that contain tyramine and caffeine .
- G. D
Correct Answer: Water, salt, and fat don't interact with MAOIs. Tyramine and caffeine can cause hypertensive crises with MAOIs.
Rationale: The correct answer is D: Foods that contain tyramine and caffeine. MAOIs inhibit the breakdown of tyramine and caffeine, leading to an accumulation in the body. Tyramine can cause a dangerous increase in blood pressure known as a hypertensive crisis. Caffeine can also contribute to this effect. Large amounts of water (A), a high-salt diet (B), and a high-fat diet (C) do not interact with MAOIs in a way that poses a significant risk. Therefore, instructing the client to avoid foods containing tyramine and caffeine is crucial to prevent potential adverse reactions.