A male client who has been taking a high-dose of a nonsteroidal anti-inflammatory drug (NSAID) comes to the clinic reporting gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client's te’ching plan?

Notify the healthcare provider of the passage of black stools.

Call the clinic if diarrhea or headache occur when taking esomeprazole.

Once pain subsides, NSAID therapy can be resumed.

Resume a diet that consists of milk, cream, and bland foods.

Answer and Explanation

The Correct Answer is A

A) Notify the healthcare provider of the passage of black stools: This is the correct response. Black stools can indicate gastrointestinal bleeding, which is a serious adverse effect of NSAID use. It's im’ortant for the client to report this symptom promptly to the healthcare provider for further evaluation and management.

B) Call the clinic if diarrhea or headache occur when taking esomeprazole: While it's im’ortant to report any adverse effects of medication to the healthcare provider, diarrhea and headache are not specific to esomeprazole and may not warrant immediate attention unless severe or persistent.

C) Once pain subsides, NSAID therapy can be resumed: This statement is incorrect. The client should avoid NSAIDs in the future, as they are likely the cause of the gastric pain and gastrointestinal bleeding. Resuming NSAID therapy would increase the risk of recurrent bleeding.

D) Resume a diet that consists of milk, cream, and bland foods: This statement is incorrect. While bland foods may be easier to tolerate during acute gastric pain, they do not address the underlying issue of gastrointestinal bleeding. Additionally, dairy products like milk and cream may exacerbate symptoms in some individuals.

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Correct Answer is B

Explanation

A) While measuring the client’s vital signs is a routine nursing intervention, the reported symptoms of confusion and blurred vision after receiving glipizide suggest the possibility of hypoglycemia. Vital signs may not provide immediate information about the client’s glucose levels or help confirm hypoglycemia. However, if the client’s symptoms persist or worsen, assessing vital signs becomes important to monitor for signs of shock or other complications.

B) Obtaining a fingerstick blood glucose is the priority action in this situation. Glipizide is an oral antidiabetic medication that stimulates insulin release from the pancreas, leading to lower blood glucose levels. Symptoms such as confusion and blurred vision are indicative of hypoglycemia, a potential adverse effect of glipizide. Checking the client’s blood glucose level will confirm hypoglycemia and guide further interventions.

C) While performing a neurological exam may be warranted if the client’s symptoms persist or if there are concerns about other neurological issues, confirming hypoglycemia with a fingerstick blood glucose test should be the immediate priority.

D) Administering glucagon intramuscularly (IM) is indicated for severe hypoglycemia when the client is unconscious or unable to swallow. However, in this scenario, the client is conscious and able to report symptoms. Before administering glucagon, it is essential to confirm hypoglycemia with a blood glucose measurement to avoid unnecessary interventions.

Therefore, the nurse should promptly obtain a fingerstick blood glucose to confirm hypoglycemia and initiate appropriate treatment for the client’s symptoms.

A. CT scan that was performed six months earlier. B. Takes metformin hydrochloride for type 2 diabetes mellitus. C. Report of client’s sobriety for the last five years. D. Metal hip prosthesis was placed twenty years ago.

Correct Answer is B

Explanation

A) CT scan that was performed six months earlier: A previous CT scan performed six months earlier does not necessarily require follow-up by the nurse. However, it would be important to review the results of the previous CT scan to compare findings and assess for any changes over time.

B) Takes metformin hydrochloride for type 2 diabetes mellitus: This is the correct answer. Metformin is excreted by the kidneys, and contrast media used in CT scans can potentially cause kidney damage, particularly in clients with pre-existing renal impairment. Therefore, clients taking metformin may be at increased risk of developing lactic acidosis if renal function is compromised. It is essential for the nurse to follow up on this information and coordinate with the healthcare provider to determine whether metformin should be temporarily discontinued before the CT scan and when it can be safely resumed.

C) Report of client’s sobriety for the last five years: The client’s sobriety status for the last five years is not directly relevant to the CT scan with contrast for evaluating pulmonary embolism. While substance use history is important for overall health assessment, it does not specifically require follow-up related to the CT scan.

D) Metal hip prosthesis was placed twenty years ago: The presence of a metal hip prosthesis placed twenty years ago may be relevant for certain imaging studies, such as magnetic resonance imaging (MRI) or metal artifact reduction sequence (MARS) MRI, but it is not directly related to the CT scan with contrast for pulmonary embolism evaluation. Therefore, it does not require immediate follow-up by the nurse in this context.

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Naxlex Comprehensive Predictor Exams

A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

Correct Answer is B

Explanation

A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client’s history requires follow up by the nurse?

Correct Answer is B

Explanation

The loop diuretic furosemide is prescribed for a client with a history of heart failure (HF). Which foods should the nurse encourage this client to eat?

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The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

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The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

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