Nokea
When providing instructions to a client taking ciprofloxacin (Cipro), which of the following should the nurse include in the teaching plan?
- A. Avoid taking the medication with milk or antacids.
- B. Take the medication with a multivitamin.
- C. Consume extra dairy products while taking this medication.
- D. Take the medication with food if gastrointestinal upset occurs.
Correct Answer: A
Rationale: The correct answer is to avoid taking ciprofloxacin (Cipro) with milk or antacids. These can interfere with the medication's absorption. Consuming extra dairy products or taking it with a multivitamin is not recommended for the same reason. If gastrointestinal upset occurs, the medication can be taken with food to help alleviate the symptoms.
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A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which medication should be prepared to administer as prescribed to the client?
- A. Calcium chloride
- B. Calcium gluconate
- C. Calcitonin (Miacalcin)
- D. Large doses of vitamin D
Correct Answer: C
Rationale: The normal serum calcium level ranges from 8.6 to 10.0 mg/dL. In hypercalcemia, as seen in this client, Calcitonin (Miacalcin) is used to decrease plasma calcium levels by inhibiting bone resorption. Calcium gluconate and calcium chloride are typically used for hypocalcemia, not hypercalcemia. Large doses of vitamin D should be avoided in hypercalcemia as they can exacerbate hypercalcemia by increasing calcium absorption from the intestines.
While assisting in caring for a pregnant client receiving intravenous magnesium sulfate for preeclampsia management, a nurse notes the client's absent deep tendon reflexes. What determination should the nurse make based on this data?
- A. The magnesium sulfate is effective.
- B. The infusion rate needs to be increased.
- C. The client is experiencing cerebral edema.
- D. The client is experiencing magnesium toxicity.
Correct Answer: D
Rationale: When a pregnant client receiving intravenous magnesium sulfate for preeclampsia management exhibits absent deep tendon reflexes, this indicates magnesium toxicity. Magnesium toxicity can occur as a complication of magnesium sulfate therapy, leading to suppressed reflexes. It is crucial for the nurse to recognize this sign promptly and report it to prevent further complications or harm to the client.
Why is prostaglandin E1 prescribed for a child with transposition of the great arteries?
- A. Prevents hypercyanotic (blue or tet) spells
- B. Maintains an adequate hormone level
- C. Maintains the position of the great arteries
- D. Provides adequate oxygen saturation and maintains cardiac output
Correct Answer: D
Rationale: Prostaglandin E1 is prescribed for a child with transposition of the great arteries to increase blood mixing, which helps maintain adequate oxygen saturation and cardiac output. This medication does not prevent hypercyanotic spells, maintain hormone levels, or influence the position of the great arteries.
The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse schedules the medication for which times?
- A. With meals and at bedtime
- B. Every 6 hours around the clock
- C. One hour after meals and at bedtime
- D. One hour before meals and at bedtime
Correct Answer: D
Rationale: Sucralfate is a gastric protectant that forms a protective coating over the ulcer. Administering sucralfate 1 hour before meals and at bedtime is important to create a barrier that protects the ulcer from gastric acid and mechanical irritation. This timing allows sucralfate to effectively coat the ulcer site and provide the desired therapeutic effect, enhancing its efficacy in promoting ulcer healing and symptom relief.
When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?
- A. Assessing the injection site for itching and edema
- B. Monitoring white blood cell counts and platelet counts
- C. Evaluating for fatigue and joint pain in the client
- D. Checking for a metallic taste in the mouth and loss of appetite
Correct Answer: B
Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.