When documenting, which of the following would be appropriate for the nurse to use at accredited health care organizations? Select one that does not apply.
- A. IU
- B. 2mg
- C. 0.2 mg
- D. Units
Correct Answer: A
Rationale: Always use a leading zero when writing decimals (i.e., 0.2 mg, not .2 mg) and leave off the trailing zero (i.e., 2 mg, not 2.0 mg). Always write out units, international units, and daily; do not use U, IU, or QD.
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A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patient's response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patient's physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
A nurse is providing teaching to a client who is starting Simvastatin. Which of the following information should the nurse include in the teaching?
- A. Take this medication in the evening.
- B. Change position slowly when rising from a chair.
- C. Maintain a steady intake of green leafy vegetables.
- D. Consume no more than 1 L/day of fluid
Correct Answer: A
Rationale: Simvastatin is taken in the evening when cholesterol synthesis peaks.
A nurse is teaching a client who has a new prescription for Dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
- A. Diarrhea
- B. Anxiety
- C. Sedation
- D. Palpitations
Correct Answer: C
Rationale: Dextromethorphan can cause sedation , a common side effect of this cough suppressant.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas?
- A. Back
- B. Axilla
- C. Soles of the feet
- D. Palms of the hands
Correct Answer: B
Rationale: Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is poor (back, palms, soles).
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are safe and do not cause adverse effects if taken properly.
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).
- C. OTC drugs are different from any drugs available by prescription and cost less.
- D. OTC drugs could cause serious harm if not taken according to directions.
Correct Answer: D
Rationale: It is important to follow package directions because OTCs are medications that can cause serious harm if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed; however, all drugs can produce adverse effects even when taken properly. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.