Exhibits

The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.

St. John's Wort

Corticosteroids

Fluconazole

Ibuprofen

Oral contraceptives

Answer and Explanation

Correct Answer : A,B,C,F

Choice A rationale: St. John's Wort is an herbal supplement that can interact with various medications, including insulin, and may alter blood glucose levels. It can reduce the effectiveness of insulin, leading to decreased blood glucose control. It is essential for the client to inform the healthcare provider about any use of St. John's Wort to adjust the insulin regimen accordingly.

Choice B rationale: Corticosteroids can increase blood glucose levels by promoting insulin resistance and inhibiting insulin action. Clients with diabetes may require adjustments in their insulin dosage while taking corticosteroids to prevent hyperglycemia.
Choice C rationale: Fluconazole is an antifungal medication that can affect blood glucose levels. It may increase the hypoglycemic effects of insulin, leading to lower blood glucose levels. The
client's insulin regimen may need to be adjusted while taking fluconazole.
Choice D rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not typically have a direct impact on blood glucose levels in people with diabetes.
Choice E rationale: Epinephrine is a hormone that may transiently increase blood glucose levels in response to stress, but it is not a home medication that the client would be taking regularly.
Choice F rationale: Oral contraceptives, specifically combination hormonal contraceptives containing estrogen and progestin, can impact blood glucose levels. They may lead to insulin resistance and, in some cases, increase blood glucose levels. The healthcare provider may need to adjust the insulin dosage for better glycemic control.

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Correct Answer is C

Explanation

A. A scratchy throat may indicate mild irritation but is not an immediate reason to stop the infusion unless it progresses.
B. Pupillary constriction is not typically associated with an acute reaction to piperacillin-tazobactam.
C. A sudden increase in blood pressure (hypertension) during the infusion may indicate a serious adverse reaction and is a valid reason to stop the infusion immediately and notify the provider.
D. Bradycardia is not commonly associated with piperacillin-tazobactam infusion reactions and would not automatically warrant stopping the infusion.

A. Low sodium antacid. B. Diphenhydramine. C. Low dose aspirin. D. Acetaminophen.

Correct Answer is A

Explanation

Choice A rationale: Heartburn when lying down after dinner can be a symptom of gastroesophageal reflux disease (GERD), which is a common concern in individuals with heart failure. Antacids are commonly used to relieve heartburn by neutralizing stomach acid. For patients with heart failure, it is essential to use low sodium antacids because excess sodium intake can worsen fluid retention and lead to increased heart failure symptoms. Low sodium antacids are specifically designed to minimize the sodium content, making them a suitable choice for individuals with heart failure.

Choice B rationale: Diphenhydramine is an antihistamine commonly used for allergy relief and as a sleep aid due to its sedative effects. However, it is not an appropriate choice for relieving heartburn. Diphenhydramine does not have any direct effect on stomach acid, and it is not indicated for GERD or heartburn relief.

Choice C rationale: Low dose aspirin is primarily used as an antiplatelet agent to reduce the risk of blood clots and is commonly prescribed for patients with certain cardiovascular conditions. However, it is not a suitable medication for relieving heartburn. In fact, aspirin can irritate the stomach lining and worsen symptoms of heartburn and gastric irritation.

Choice D rationale: Acetaminophen is a common over-the-counter pain reliever and fever reducer. While it is useful for managing pain and fever, it does not have any effect on stomach acid and is not indicated for heartburn relief. Acetaminophen is not an appropriate choice for addressing heartburn symptoms.

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Exhibits The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion?

Correct Answer is C

Explanation

A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?

Correct Answer is A

Explanation

Exhibits For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client's first dose of captopril.

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Exhibits The provider would like the client to continue with the captopril dose and restart the spironolactone. The provider wants the client to return to the clinic in 6 weeks with lab work done. What 2 labs would be most appropriate for this client to complete on their return visit?

Exhibits The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril. Which ACE inhibitors can be given only once per day? Select all that apply.

Exhibits

The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.