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When implementing patient teaching for a patient admitted with hyperglycemia and newly diagnosed diabetes mellitus scheduled for discharge the second day after admission, what is the priority action for the nurse?
- A. Instruct about the increased risk for cardiovascular disease.
- B. Provide detailed information about dietary control of glucose.
- C. Teach glucose self-monitoring and medication administration.
- D. Give information about the effects of exercise on glucose control.
Correct Answer: C
Rationale: The correct answer is C because teaching glucose self-monitoring and medication administration is the priority action to ensure the patient can manage their condition effectively post-discharge. This step is crucial for immediate management of hyperglycemia and newly diagnosed diabetes mellitus. Option A is incorrect as addressing cardiovascular risk can be important but not the immediate priority. Option B is important but not as urgent as self-monitoring and medication administration. Option D is also important for long-term management but not as critical as ensuring immediate control of blood glucose levels through monitoring and medication.
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A patient with a diagnosis of peptic ulcer disease is prescribed omeprazole. When should the patient take this medication for optimal effectiveness?
- A. With meals
- B. At bedtime
- C. Before meals
- D. After meals
Correct Answer: C
Rationale: The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works by reducing stomach acid production. Taking it before meals allows the medication to be most effective in inhibiting the proton pumps before they are stimulated by food intake. This timing optimizes the drug's ability to reduce acid secretion during the digestion process.
Choice A (With meals) is incorrect because taking omeprazole with meals may reduce its effectiveness as it will not have enough time to inhibit acid production before food intake. Choice B (At bedtime) is also incorrect as omeprazole works best when taken before meals to prevent acid production. Choice D (After meals) is incorrect because waiting until after meals to take omeprazole means that acid production has already been stimulated by the food consumed, reducing the drug's effectiveness in inhibiting acid secretion.
What side effect should be monitored for in a patient with chronic heart failure taking spironolactone?
- A. Hypokalemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypernatremia
Correct Answer: B
Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. It works by blocking the aldosterone receptor, leading to potassium retention and potential hyperkalemia. Monitoring potassium levels is crucial as hyperkalemia can increase the risk of arrhythmias and other cardiac complications in heart failure patients.
A: Hypokalemia is incorrect because spironolactone typically causes potassium retention.
C: Hyponatremia and D: Hypernatremia are incorrect as spironolactone does not directly affect sodium levels.
In summary, monitoring for hyperkalemia is essential in patients with heart failure taking spironolactone to prevent adverse cardiac events.
What is the most appropriate nursing intervention to help alleviate severe abdominal pain in a patient with acute pancreatitis?
- A. Encourage oral intake of clear fluids.
- B. Place the patient in a supine position.
- C. Administer prescribed opioid analgesics.
- D. Apply a heating pad to the abdomen.
Correct Answer: C
Rationale: The correct answer is C, administering prescribed opioid analgesics. This intervention is appropriate for severe abdominal pain in acute pancreatitis as opioids are effective in managing pain. Encouraging oral intake (A) can worsen symptoms, a supine position (B) can exacerbate pain, and a heating pad (D) can aggravate inflammation. Administering opioid analgesics provides direct pain relief and is the most effective intervention for alleviating severe abdominal pain in acute pancreatitis.
A patient with gout is prescribed allopurinol. What should the nurse include in the patient teaching?
- A. Take the medication with food.
- B. Increase intake of high-purine foods.
- C. Limit fluid intake to 1 liter per day.
- D. Expect immediate pain relief.
Correct Answer: A
Rationale: The correct answer is A: Take the medication with food. Allopurinol can cause stomach upset, so taking it with food can help minimize gastrointestinal side effects. Taking it on an empty stomach may increase the risk of nausea or stomach pain. Choice B is incorrect because increasing high-purine foods can exacerbate gout symptoms. Choice C is incorrect because limiting fluid intake can lead to dehydration, which is not recommended for gout patients. Choice D is incorrect because allopurinol does not provide immediate pain relief; it works to lower uric acid levels over time to prevent gout attacks.
A patient with heart failure is prescribed digoxin. What is the most important instruction the nurse should provide?
- A. Take an extra dose if you miss one.
- B. Avoid high-potassium foods.
- C. Report any visual disturbances.
- D. Stop taking the medication if your pulse is normal.
Correct Answer: C
Rationale: The correct answer is C: Report any visual disturbances. This is important because digoxin can cause visual disturbances, such as blurred or yellow-tinted vision, which may indicate toxicity. By reporting these symptoms promptly, the nurse can prevent serious complications.
A: Taking an extra dose if a dose is missed can lead to overdose and toxicity.
B: Avoiding high-potassium foods is important for patients taking potassium-sparing diuretics, not digoxin.
D: Stopping the medication if the pulse is normal is incorrect as it should be taken as prescribed for heart failure management.