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When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?
- A. Expect the development of a mild rash.
- B. Take the medication on an empty stomach.
- C. Monitor for signs of gingival hyperplasia.
- D. Increase your intake of calcium.
Correct Answer: C
Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.
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Assessing a patient after intravenous morphine administration, the nurse notes cold, clammy skin; a pulse of 40 beats/min; respirations of 10 breaths/min; and constricted pupils. Which medication will the patient likely need next?
- A. Naloxone
- B. Meloxicam
- C. Pentazocine
- D. Propoxyphene
Correct Answer: A
Rationale: The patient's symptoms—cold, clammy skin, bradycardia, respiratory depression, and constricted pupils—are classic signs of opioid overdose. Naloxone is the antidote for opioid overdose and should be administered immediately to reverse the life-threatening effects of morphine. Meloxicam, pentazocine, and propoxyphene are not appropriate in this situation. Nurses must recognize the signs of opioid toxicity and act quickly to administer naloxone, ensuring the patient's airway, breathing, and circulation are supported.
When educating a client with a new prescription for Omeprazole to manage GERD, which of the following information should the nurse include?
- A. Take the medication before meals.
- B. You may need to take this medication for a long time.
- C. Increase your intake of vitamin C while taking this medication.
- D. Expect immediate relief of symptoms.
Correct Answer: A
Rationale: The correct answer is to take the medication before meals. Omeprazole should be taken before meals to ensure its effectiveness in reducing stomach acid production. This timing allows the medication to work on reducing acid secretion when the stomach is most actively producing it, leading to better control of symptoms. Choice B is incorrect because not all patients with GERD need to take Omeprazole for the rest of their lives; the duration of treatment varies. Choice C is incorrect as there is no specific recommendation to increase vitamin C intake while taking Omeprazole. Choice D is incorrect because Omeprazole may take a few days to start providing symptom relief, so immediate relief should not be expected.
When educating a patient about Regular Insulin, you should include which instruction:
- A. Shake the vial vigorously
- B. Expect the solution to appear cloudy
- C. Store unopened vials at room temperature
- D. Inject the insulin subcutaneously
Correct Answer: D
Rationale: When educating a patient about Regular Insulin, you should include the instruction to inject the insulin subcutaneously. Regular insulin is a short-acting insulin that should be injected into the subcutaneous tissue rather than intramuscularly or intravenously. Subcutaneous injection ensures proper absorption and effectiveness of the insulin. It is important to educate the patient on the correct injection technique and site rotation to optimize insulin absorption and minimize the risk of lipodystrophy.
The client tells the nurse that her symptoms have become worse since she has been using oxymetazoline (Afrin) for nasal congestion. What is the best assessment question for the nurse to ask?
- A. How old is the bottle you are using?'
- B. May I take your temperature?'
- C. Are you using any other inhaled medications?'
- D. How long have you been using the medication?'
Correct Answer: D
Rationale: Oxymetazoline, a nasal decongestant, can cause rebound congestion (rhinitis medicamentosa) if used beyond 3-5 days, worsening symptoms due to vascular dependence. The best assessment question is how long the client has used it, as prolonged use is the likely culprit, guiding the nurse to educate on discontinuation or seek medical advice. The bottle's age might affect potency but isn't the primary concern for worsening symptoms. Temperature checks for infection, a secondary issue here. Other inhaled medications could interact but don't directly explain rebound effects. The nurse prioritizes duration to pinpoint misuse, a common issue with topical decongestants, making choice D critical for accurate assessment and intervention.
A client has a new prescription for Calcitonin-Salmon for Osteoporosis. Which of the following instructions should the nurse include in the teaching?
- A. Administer the medication intramuscularly.
- B. Swallow the medication whole.
- C. Inject the medication subcutaneously.
- D. Expect nasal bleeding with this medication.
Correct Answer: C
Rationale: When teaching a client about Calcitonin-Salmon for Osteoporosis, the nurse should include instructions to inject the medication subcutaneously or administer it intranasally. Option A is incorrect because Calcitonin-Salmon is not typically administered intramuscularly. Option B is incorrect because it is not meant to be swallowed. Option D is incorrect as nasal bleeding is not an expected side effect with this medication.