For which clients should the nurse withhold the initial dose of a cyclooxygenase 2 (COX-
2) inhibitor until notifying the health care provider? (Select all that apply.)
A. A middle-aged adult with a history of tinnitus while taking aspirin
B. A middle-aged adult with a history of polycystic ovarian disease
C. An older adult with a history of a skin rash while taking glyburide (DiaBeta)
D. An adolescent with a history of an anaphylactic reaction to penicillin
E. An older adult with a history of gastrointestinal upset while taking naproxen sodium
(Naprosyn)
F. An adolescent at 34 weeks of gestation experiencing 1+ pitting edema
Not quite, you're still learning!
, B. Uric acid level C, D, F
The primary therapeutic COX-2 inhibitors are
outcome associated with contraindicated for those who
allopurinol therapy is reduced are allergic to sulfa drugs (C),
serum uric acid levels with a aspirin, and nonsteroidal
lower frequency of acute gouty antiinflammatory drugs
attacks, so option B should be (NSAIDs). Drug safety for
reported to the health care adolescents (D and F) is not yet
provider. Options A, C, and D established, and COX-2
are not related to the inhibitors, as well as NSAIDs, are
effectiveness of allopurinol. contraindicated during the third
trimester of pregnancy (F)
because they can cause a
premature closure of the patent
ductus arteriosus. Tinnitus, an
adverse reaction of aspirin (A),
and ovarian disease (B) are not
contraindications for the use of
COX-2 inhibitors.
Gastrointestinal upset is a
common adverse reaction of
NSAIDs (E) but is not a
contraindication for the use of a
COX-2 inhibitor.
The nurse has completed diabetic teaching for a client who has been newly diagnosed
with diabetes mellitus. Which statement by this client would indicate to the nurse that
further teaching is needed?
A. "Regular insulin can be stored at room temperature for 30 days."
B. "My legs, arms, and abdomen are all good sites to inject my insulin."
C. "I will always carry hard candies to treat hypoglycemic reactions."
D. "When I exercise, I should plan to increase my insulin dosage."
Give this one a try later!
, D. "When I exercise, I should plan to increase my insulin dosage."
Exercise helps facilitate the entry of glucose into the cell, so increasing insulin
doses with exercise would place the client at high risk for a hypoglycemic
reaction. Options A, B, and C reflect accurate statements about the use of
insulin and management of hypoglycemic reactions.
Which intervention is most important for a nurse to implement prior to administering
atropine PO?
A. Determine the presence of 5 to 35 bowel sounds/min.
B. Provide oral care prior to administration.
C. Verify that the client's tendon reflexes are 2+.
D. Have the client rate his or her pain on a 0 to10 scale.
Give this one a try later!
A. Determine the presence of 5 to 35 bowel sounds/min.
Anticholinergic drugs, such as atropine, have antispasmodic and antisecretory
properties, which relax the gastrointestinal tract, and are therefore
contraindicated in a client with intestinal atony. Oral care may be required
after administration since atropine can dry secretions. Option B (used to
determine dehydration) or (C). Atropine itself has no analgesic effect; it is used
with opioids to potentiate their effect.
A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2
mL. How many milliliters should be administered?
A. 1.8
B. 2.0
, C. 2.4
D. 2.2
Give this one a try later!
D. 2.2
(22 mg/20 mg) × (x mL/2 mL) = 22x = 40
x = 2.2 mL
Which statement indicates that client teaching regarding the administration of the
chemotherapeutic agent daunorubicin HCl has been effective?
A. "I should use an astringent mouthwash after every meal."
B. "I will eat high-fiber foods and drink lots of water."
C. "I expect my urine to be red for the next few days."
D. "I should use sunscreen when I spend time outdoors."
Give this one a try later!
C. "I expect my urine to be red for the next few days."
Daunorubicin HCl causes the urine to turn red in color. Option A is not
recommended. Options B and D are interventions that promote general good
health but are not specific to treatment with daunorubicin HCl.
A client is receiving pyridostigmine bromide to control the symptoms of myasthenia
gravis. Which client behavior would indicate that the drug therapy is effective?
A. Decreased oral secretions
B. Clear speech
2) inhibitor until notifying the health care provider? (Select all that apply.)
A. A middle-aged adult with a history of tinnitus while taking aspirin
B. A middle-aged adult with a history of polycystic ovarian disease
C. An older adult with a history of a skin rash while taking glyburide (DiaBeta)
D. An adolescent with a history of an anaphylactic reaction to penicillin
E. An older adult with a history of gastrointestinal upset while taking naproxen sodium
(Naprosyn)
F. An adolescent at 34 weeks of gestation experiencing 1+ pitting edema
Not quite, you're still learning!
, B. Uric acid level C, D, F
The primary therapeutic COX-2 inhibitors are
outcome associated with contraindicated for those who
allopurinol therapy is reduced are allergic to sulfa drugs (C),
serum uric acid levels with a aspirin, and nonsteroidal
lower frequency of acute gouty antiinflammatory drugs
attacks, so option B should be (NSAIDs). Drug safety for
reported to the health care adolescents (D and F) is not yet
provider. Options A, C, and D established, and COX-2
are not related to the inhibitors, as well as NSAIDs, are
effectiveness of allopurinol. contraindicated during the third
trimester of pregnancy (F)
because they can cause a
premature closure of the patent
ductus arteriosus. Tinnitus, an
adverse reaction of aspirin (A),
and ovarian disease (B) are not
contraindications for the use of
COX-2 inhibitors.
Gastrointestinal upset is a
common adverse reaction of
NSAIDs (E) but is not a
contraindication for the use of a
COX-2 inhibitor.
The nurse has completed diabetic teaching for a client who has been newly diagnosed
with diabetes mellitus. Which statement by this client would indicate to the nurse that
further teaching is needed?
A. "Regular insulin can be stored at room temperature for 30 days."
B. "My legs, arms, and abdomen are all good sites to inject my insulin."
C. "I will always carry hard candies to treat hypoglycemic reactions."
D. "When I exercise, I should plan to increase my insulin dosage."
Give this one a try later!
, D. "When I exercise, I should plan to increase my insulin dosage."
Exercise helps facilitate the entry of glucose into the cell, so increasing insulin
doses with exercise would place the client at high risk for a hypoglycemic
reaction. Options A, B, and C reflect accurate statements about the use of
insulin and management of hypoglycemic reactions.
Which intervention is most important for a nurse to implement prior to administering
atropine PO?
A. Determine the presence of 5 to 35 bowel sounds/min.
B. Provide oral care prior to administration.
C. Verify that the client's tendon reflexes are 2+.
D. Have the client rate his or her pain on a 0 to10 scale.
Give this one a try later!
A. Determine the presence of 5 to 35 bowel sounds/min.
Anticholinergic drugs, such as atropine, have antispasmodic and antisecretory
properties, which relax the gastrointestinal tract, and are therefore
contraindicated in a client with intestinal atony. Oral care may be required
after administration since atropine can dry secretions. Option B (used to
determine dehydration) or (C). Atropine itself has no analgesic effect; it is used
with opioids to potentiate their effect.
A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2
mL. How many milliliters should be administered?
A. 1.8
B. 2.0
, C. 2.4
D. 2.2
Give this one a try later!
D. 2.2
(22 mg/20 mg) × (x mL/2 mL) = 22x = 40
x = 2.2 mL
Which statement indicates that client teaching regarding the administration of the
chemotherapeutic agent daunorubicin HCl has been effective?
A. "I should use an astringent mouthwash after every meal."
B. "I will eat high-fiber foods and drink lots of water."
C. "I expect my urine to be red for the next few days."
D. "I should use sunscreen when I spend time outdoors."
Give this one a try later!
C. "I expect my urine to be red for the next few days."
Daunorubicin HCl causes the urine to turn red in color. Option A is not
recommended. Options B and D are interventions that promote general good
health but are not specific to treatment with daunorubicin HCl.
A client is receiving pyridostigmine bromide to control the symptoms of myasthenia
gravis. Which client behavior would indicate that the drug therapy is effective?
A. Decreased oral secretions
B. Clear speech
