Which of the following over-the-counter medications should the nurse identify that the client should discontinue when starting lithium?
- A. Aspirin
- B. Ibuprofen
- C. Famotidine
- D. Bisacodyl
Correct Answer: B
Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase lithium levels and lead to toxicity. NSAIDs compete with lithium for renal excretion, resulting in higher lithium levels. Aspirin (choice A) is not typically contraindicated with lithium. Famotidine (choice C) and Bisacodyl (choice D) do not have significant interactions with lithium.
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Which of the following actions is the priority for the nurse to take after inadvertently administering 160 mg of valsartan PO to a client who was scheduled to receive 80 mg?
- A. Evaluate the client for orthostatic hypotension
- B. Monitor the client's urine output
- C. Obtain the client's laboratory results
- D. Check the client for nasal congestion
Correct Answer: A
Rationale: The correct answer is A: Evaluate the client for orthostatic hypotension. After administering a double dose of Valsartan, the priority is to assess the client for potential adverse effects such as a sudden drop in blood pressure, which can lead to orthostatic hypotension. This is crucial to prevent any harm to the client. Monitoring urine output (B) may be important but is not the immediate priority. Obtaining laboratory results (C) would not provide immediate information on the client's current condition. Checking for nasal congestion (D) is irrelevant to the situation.
For which of the following adverse effects should the nurse instruct the client taking acetazolamide for chronic open-angle glaucoma to monitor and report?
- A. Tingling of fingers
- B. Constipation
- C. Weight gain
- D. Oliguria
Correct Answer: A
Rationale: The correct answer is A: Tingling of fingers. Acetazolamide is a diuretic commonly used to treat glaucoma. Tingling of fingers is associated with electrolyte imbalances caused by the drug's diuretic effect. This symptom may indicate hypokalemia, a potential side effect of acetazolamide. Monitoring and reporting this symptom promptly can prevent serious complications.
Other choices are incorrect because:
B: Constipation is not a common side effect of acetazolamide.
C: Weight gain is unlikely as acetazolamide is a diuretic causing fluid loss.
D: Oliguria, decreased urine output, is not a usual side effect of acetazolamide.
A nurse is teaching a client about cyclobenzaprinWhich of the following client statements should indicate to the nurse that the teaching about cyclobenzaprine was effective?
- A. I will have increased saliva production
- B. I will continue taking the medication until the rash disappears
- C. I will taper off the medication before discontinuing it
- D. I will report any urinary incontinence
Correct Answer: C
Rationale: Correct Answer: C. "I will taper off the medication before discontinuing it."
Rationale: Tapering off cyclobenzaprine is important to prevent withdrawal symptoms due to its muscle relaxant properties. Abruptly stopping the medication can lead to adverse effects. This statement indicates understanding of proper medication management.
Incorrect Choices:
A: Increased saliva production is not a common side effect of cyclobenzaprine.
B: Continuing the medication until the rash disappears is not relevant to cyclobenzaprine.
D: Reporting urinary incontinence is important but not specifically related to cyclobenzaprine teaching.
Which of the following medications interacts with carbamazepine?
- A. Nicotine transdermal system
- B. Diphenhydramine
- C. Estrogen-progestin combination (Non-hormonal forms of contraception)
- D. Beclomethasone
Correct Answer: C
Rationale: The correct answer is C: Estrogen-progestin combination (Non-hormonal forms of contraception). Carbamazepine induces the metabolism of estrogen-based contraceptives, leading to decreased efficacy and potential contraceptive failure. This interaction can result in unintended pregnancies. Choices A, B, and D do not have significant interactions with carbamazepine.
How many mg should the nurse administer per dose to a child weighing 44 lbs if the prescribed dose is 15 mg/kg every 12 hours?
- A. 150 mg
- B. 200 mg
- C. 300 mg
- D. 350 mg
- E. 400 mg
Correct Answer: C
Rationale: To calculate the correct dose, we first convert the child's weight from pounds to kilograms (44 lbs ÷ 2.2 = 20 kg). Then, we multiply the weight by the prescribed dose (20 kg x 15 mg/kg = 300 mg). Therefore, the nurse should administer 300 mg per dose. Choice A is too low, choices B and D are higher than the correct answer, and choice E is significantly higher, exceeding the calculated dose.