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When teaching a client with a new prescription for Ipratropium, which of the following instructions should the nurse include?
- A. This medication can be used as a rescue inhaler.
- B. This medication should be taken before albuterol.
- C. Wait 5 minutes between medications if two inhaled medications are prescribed.
- D. Ipratropium can be used before exercise.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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After administering the drug Atropine to a patient, the nurse notices side effects of dry mouth, tachycardia, and drowsiness. The nurse suspects ans overdose of the drug. Which of the following is the antidote for Atropine?
- A. Flumazenil
- B. Naloxone
- C. Physostigmine
- D. Protamine sulfate
Correct Answer: C
Rationale: Physostigmine is the antidote for Atropine overdose. Atropine is an anticholinergic drug that blocks the action of acetylcholine. Physostigmine works by increasing the levels of acetylcholine in the body, counteracting the effects of Atropine. It can help reverse the side effects of Atropine overdose, such as dry mouth, tachycardia, and drowsiness. Flumazenil is the antidote for benzodiazepines, Naloxone is the antidote for opioids, and Protamine sulfate is the antidote for heparin.
A patient in the clinic reports difficulty tolerating the current ACE inhibitor medication, and questions if another medication could be used. The nurse correctly suspects the prescriber will choose which medication, which affects the renin-angiotensin-aldosterone system?
- A. atenolol
- B. losartan
- C. spironolactone
- D. adenosine
Correct Answer: B
Rationale: Losartan is an angiotensin II receptor blocker (ARB) that affects the renin-angiotensin-aldosterone system (RAAS) and is often used as an alternative to ACE inhibitors. Atenolol (A) is a beta-blocker, spironolactone (C) is a potassium-sparing diuretic, and adenosine (D) is used for arrhythmias. ARBs like losartan are preferred for patients who cannot tolerate ACE inhibitors due to side effects like cough or angioedema.
A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?
- A. Uroprotectant agent, such as mesna
- B. Opioid, such as morphine
- C. Loop diuretic, such as furosemide
- D. H1 receptor antagonist, such as diphenhydramine
Correct Answer: A
Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.
A client has a new prescription for Enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the following adverse reactions?
- A. Bone marrow suppression
- B. Pancreatitis
- C. Pancreatitis
- D. Bone marrow suppression
Correct Answer: D
Rationale: While bone marrow suppression is not typically associated with Enfuvirtide, a more relevant concern is the risk of severe allergic reactions such as anaphylaxis. Enfuvirtide, an HIV fusion inhibitor, can cause local injection site reactions and systemic allergic responses. Monitoring for signs of allergic reactions, such as rash, fever, and difficulty breathing, is crucial to ensure the client's safety.
The nurse is discharging a 35-year-old patient with diabetes who has been prescribed an adrenergic blocking agent. What is the priority teaching point for the nurse to discuss with this patient?
- A. Monitor blood glucose levels closely and report any instability
- B. Document signs and symptoms of hyperglycemia and hypoglycemia
- C. Reduce carbohydrate intake more than usual while taking the new drug
- D. Increase insulin dosage to compensate for the drug’s effect in increasing blood sugar
Correct Answer: A
Rationale: It is important for the patient to be instructed to monitor blood sugar levels more frequently because adrenergic blocking agents mask the normal hypo- and hyperglycemic manifestations that normally alert patients such as sweating, feeling tense, increased heart rate, and rapid breathing. There is no need to change the diet or the diabetic medications. There may be no signs and symptoms to record because they are blocked by the adrenergic blocker. The nurse should emphasize the importance of frequent blood glucose monitoring and reporting any instability to the healthcare provider.