A client with peptic ulcer disease (PUD) is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0730. The client reports experiencing heartburn when the nurse brings the scheduled medications. Which action should the nurse take?

Hold the dose of IV pantoprazole until the client has finished eating breakfast.

Provide a PRN dose of antacid along with the scheduled medications.

Instruct the client to take the dose of sucralfate PO while eating breakfast.

Administer both of the medications before breakfast as scheduled.

Answer and Explanation

The Correct Answer is D

A) Holding the dose of IV pantoprazole until the client has finished eating breakfast may delay the onset of action of the medication, as pantoprazole is typically administered before meals to maximize its effectiveness in reducing gastric acid secretion. Additionally, delaying the dose may not provide immediate relief for the client's he’rtburn symptoms.

B) Providing a PRN dose of antacid along with the scheduled medications may temporarily relieve the client's he’rtburn symptoms, but it does not address the underlying cause of peptic ulcer disease or prevent further gastric acid secretion, which is the primary goal of pantoprazole and sucralfate administration.

C) Instructing the client to take the dose of sucralfate PO while eating breakfast may interfere with the optimal absorption of the medication. Sucralfate forms a protective barrier over ulcers in the stomach and should be administered on an empty stomach to allow it to adhere to the gastric mucosa effectively.

D) Administering both of the medications before breakfast as scheduled is the most appropriate action. Pantoprazole is a proton pump inhibitor that reduces gastric acid production, and sucralfate forms a protective barrier over ulcers in the stomach. Administering these medications before breakfast allows them to work synergistically to reduce gastric acid secretion and protect the gastric mucosa, helping to alleviate the client's he’rtburn symptoms and promote ulcer healing.

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Correct Answer is D

Explanation

Begin cardioversion to stabilize heart rhythm: Cardioversion is not the appropriate intervention for digoxin toxicity. Digoxin toxicity can cause arrhythmias, but the initial action should be to assess and manage the underlying cause, rather than immediately proceeding to cardioversion.

B) Give digoxin by another route to slow absorption: Slowing the absorption of digoxin is not the appropriate action for treating digoxin toxicity. Instead, the focus should be on managing the existing toxicity and preventing further absorption by withholding additional doses.

C) Administer potassium to stabilize the heart rate: While potassium may be indicated as part of the treatment for digoxin toxicity, particularly if hypokalemia is contributing to the toxicity, it is not the initial action. The priority is to assess the client’s acid-base and electrolyte values to identify any abnormalities contributing to the toxicity.

D) Check acid-base and electrolyte values: This is the correct action. Digoxin toxicity can be exacerbated by electrolyte imbalances, particularly hypokalemia, hypercalcemia, and hypomagnesemia. Therefore, assessing the client’s acid-base and electrolyte values is essential to identify and correct any abnormalities contributing to the toxicity. Once identified, appropriate interventions can be implemented to manage the toxicity and stabilize the client’s condition.

A. Deep-fried shrimp. B. Pan-seared catfish. C. Pepperoni pizza. D. Beef tips with gravy.

Correct Answer is C

Explanation

A) Deep-fried shrimp: While deep-fried foods are generally high in fat and calories, there is no specific contraindication for clients taking phenelzine to avoid deep-fried shrimp. However, clients with hypertension may benefit from reducing their intake of high-fat foods.

B) Pan-seared catfish: Pan-seared catfish is a relatively lean protein source and does not contain ingredients known to interact with phenelzine. However, clients with hypertension may benefit from limiting their intake of high-sodium foods, such as pan-seared catfish if it is prepared with added salt.

C) Pepperoni pizza: Pepperoni pizza is a high-sodium food due to its processed meat toppings and cheese, and it may contain ingredients that interact with phenelzine. Phenelzine is a monoamine oxidase inhibitor (MAOI), and consuming foods high in tyramine, such as aged or fermented foods like pepperoni, can lead to hypertensive crisis. Therefore, the nurse should instruct the client to avoid pepperoni pizza to prevent potential interactions and exacerbation of hypertension.

D) Beef tips with gravy: While beef tips with gravy may be high in sodium depending on how it is prepared, there is no specific contraindication for clients taking phenelzine to avoid this food. However, clients with hypertension may benefit from choosing lean cuts of beef and limiting their intake of high-sodium gravies.

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A client with peptic ulcer disease (PUD) is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0730. The client reports experiencing heartburn when the nurse brings the scheduled medications. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing the client’s laboratory results. Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Correct Answer is D

Explanation

A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?

Correct Answer is C

Explanation

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