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Which action should be taken to assess for analgesic tolerance in a client who is unable to communicate?
- A. Review the client's laboratory values for changes in peak and trough levels of the analgesic
- B. Prolong the interval between analgesic medication doses and monitor the client's vital signs
- C. Observe the client for the presence of pain behaviors before the next analgesic dose is due
- D. Ask family members to report behaviors suggesting that the client's pain has returned
Correct Answer: C
Rationale: In clients who are unable to communicate, observing for pain behaviors is crucial in assessing analgesic tolerance. Changes in pain behaviors can indicate if the current analgesic regimen is effective or if tolerance has developed. Therefore, closely observing the client for pain behaviors before the next analgesic dose helps healthcare providers evaluate the client's response to pain management.
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The healthcare professional is caring for a patient with a new order for an oral laxative. Which is a contraindication in administering an oral laxative?
- A. Cardiac problems
- B. Abdominal pain of unknown origin
- C. Several hemorrhoids
- D. Chronic constipation
Correct Answer: B
Rationale: Administering an oral laxative to a patient with abdominal pain of unknown origin is contraindicated because it could be a sign of a more serious underlying condition that needs immediate medical evaluation. Giving a laxative in such a situation without proper diagnosis could potentially worsen the patient's condition or delay appropriate treatment.
A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse (PN) reinforce to this client?
- A. Maintain consistent sodium intake.
- B. Use sunscreen when outdoors.
- C. Return for monthly urinalysis.
- D. Brush and floss teeth daily.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with a history of deep vein thrombosis is prescribed fondaparinux. The nurse should monitor for which potential adverse effect?
- A. Increased risk of bleeding
- B. Decreased risk of bleeding
- C. Increased risk of infection
- D. Decreased risk of infection
Correct Answer: A
Rationale: Corrected Question: When a client with a history of deep vein thrombosis is prescribed fondaparinux, the nurse should monitor for the potential adverse effect of an increased risk of bleeding. Fondaparinux is an anticoagulant that works by preventing blood clots, which can lead to an increased risk of bleeding. Therefore, the nurse should closely monitor the client for signs of bleeding, such as unexplained bruising, bleeding gums, or blood in the urine or stool.
How should the healthcare provider schedule the administering of propylthiouracil (PTU)?
- A. Offer both drugs together with a meal
- B. Give parental dose once every 24 hours
- C. Schedule both medications at bedtime
- D. Administer iodine one hour before PTU
Correct Answer: D
Rationale: Administering iodine one hour before PTU is crucial to ensure proper absorption and effectiveness of PTU. This timing helps optimize the therapeutic benefits of PTU by allowing it to be absorbed efficiently without interference from iodine, ultimately leading to better treatment outcomes for the patient.
A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?
- A. Apical heart rate of 60 beats/min
- B. Sweating across the forehead
- C. Poor sucking effort
- D. Respiratory rate of 30 breaths/min
Correct Answer: A
Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects.