Nokea
Which of the following statements should the nurse include in the teaching about the new medication?
- A. You should take this medication with dairy products.
- B. This medication may cause constipation.
- C. It is common to experience headache or blurred vision while taking this medication.
- D. You should avoid the sun while taking this medication.
- E. You should use an alternate method of birth control while taking this medication.
Correct Answer: D
Rationale: The correct answer is D: You should avoid the sun while taking this medication. This is important because some medications can increase sensitivity to sunlight, leading to sunburn or skin reactions. Avoiding the sun can prevent these adverse effects.
A: You should not take this medication with dairy products as it may interfere with the absorption of the medication.
B: Constipation is a common side effect of some medications, but it is not specific to this particular medication.
C: Headache or blurred vision may occur with some medications, but it is not specific to this particular medication.
E: Using an alternate method of birth control may be necessary if the medication interferes with hormonal contraceptives, but this information is not provided in the question stem.
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A nurse inadvertently administers 160 mg of valsartan PO to a client who was scheduled to receive 80 mg. Which of the following actions is the priority for the nurse to take?
- 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. This is the priority because an overdose of valsartan, a medication used to treat hypertension, can lead to a sudden drop in blood pressure. Orthostatic hypotension is a potential complication that can result from this overdose, and it requires immediate assessment and intervention to prevent further complications such as falls or decreased perfusion to vital organs. Monitoring urine output (B) is important for some medications but is not the priority in this case. Obtaining laboratory results (C) may be necessary in the long term but is not urgent in this situation. Checking for nasal congestion (D) is not relevant to the issue at hand.
A nurse is providing teaching to a client about the administration of omeprazole. Which of the following should the nurse include?
- A. You cannot take this medication with an antacid.
- B. You should reduce your intake of calcium while taking this medication.
- C. You should take this medication before meals.
- D. You can take a second dose if symptoms persist up to 2 hours after the first dose.
Correct Answer: C
Rationale: Rationale: Choice C is correct because omeprazole is a proton pump inhibitor that works best when taken before meals to inhibit gastric acid secretion. This timing ensures optimal effectiveness of the medication. Choices A, B, and D are incorrect. Choice A is inaccurate because omeprazole can be taken with antacids, but it is recommended to be taken separately. Choice B is incorrect as there is no specific need to reduce calcium intake while taking omeprazole. Choice D is incorrect as taking a second dose without medical advice may lead to overdosing and adverse effects.
A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?
- A. Protamine sulfate
- B. Acetylcysteine
- C. Calcium gluconate
- D. Flumazenil
Correct Answer: C
Rationale: The correct answer is C: Calcium gluconate. In hypermagnesemia, there is an excess of magnesium in the blood, leading to muscle weakness, cardiac arrhythmias, and respiratory depression. Calcium gluconate is the antidote for hypermagnesemia as it works by antagonizing the effects of magnesium. By administering calcium gluconate, the nurse can help reverse the symptoms associated with hypermagnesemia and restore normal calcium levels in the body. Protamine sulfate (Choice A) is used to reverse the effects of heparin, acetylcysteine (Choice B) is used as an antidote for acetaminophen overdose, and flumazenil (Choice D) is used to reverse the effects of benzodiazepines. These medications are not indicated for hypermagnesemia.
A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which of the following actions should the nurse take first?
- A. Encourage the client to dangle the legs while sitting in a chair
- B. Teach the client about foods low in sodium
- C. Determine medication adherence by the client
- D. Notify the provider of the client's weight gain
Correct Answer: D
Rationale: The correct answer is D: Notify the provider of the client's weight gain. This is the first action the nurse should take because sudden weight gain in a client with heart failure could indicate fluid retention, which may worsen the client's condition. By notifying the provider, the nurse can ensure timely intervention to adjust the medication or treatment plan. Encouraging leg dangling (A) may help with circulation but does not address the immediate concern of weight gain. Teaching about low-sodium foods (B) is important for long-term management but not the priority at this moment. Determining medication adherence (C) is important but should come after addressing the immediate weight gain issue.
A nurse is reviewing a client's 0800 laboratory values at 1100. The nurse notes that the client received heparin at 1000. Which of the following laboratory values warrants an incident report?
- A. ePTT 90 seconds
- B. Hgb 16 g/dL
- C. INR 1.6
- D. WBC 6,000/mm3
Correct Answer: A
Rationale: The correct answer is A: ePTT 90 seconds. This value indicates a higher than normal clotting time, which could potentially lead to bleeding complications due to excessive anticoagulation from heparin. The other values (B, C, D) are within normal ranges and do not indicate an immediate risk or adverse outcome related to heparin administration. An incident report is necessary to document and address the elevated ePTT to ensure appropriate interventions are taken to prevent harm to the patient.