Question

The nurse is preparing to administer ibuprofen to a client. To minimize the risk of gastric distress and bleeding, how should the nurse administer this medication?

Answer 1

Correct Answers:

Administer the ibuprofen on an empty stomach to enhance absorption

Rationale :

🔷 Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastric irritation, ulceration, and bleeding by inhibiting prostaglandin synthesis, which normally protects the stomach lining.

🔷 To reduce this risk, it should be taken with meals, milk, or a snack, which helps buffer the stomach and prevent gastric upset.

🔷 Administering ibuprofen on an empty stomach may improve absorption slightly but significantly increases risk of gastric distress.

🔷 Crushing tablets is unnecessary unless prescribed in liquid form, and ibuprofen is absorbed primarily in the small intestine, not the large intestine.

🔷 Sitting upright after administration is important for some medications (e.g., bisphosphonates like alendronate) to prevent esophageal irritation, but it is not required for ibuprofen.

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Answer 2

Correct Answers:

Visual disturbances such as yellow halos
Anorexia and nausea

Rationale :

✅ Visual disturbances such as yellow halos

🔷 One of the classic signs of digoxin toxicity is visual changes, particularly xanthopsia (seeing yellow or green halos around lights). Clients may also report blurred vision, double vision (diplopia), or overall visual impairment.

🔷 This occurs because digoxin affects the optic nerve and retinal processing, producing altered color perception.

🔷 Since this symptom is unique to digoxin toxicity, it is a very useful early clinical clue for nurses and providers to identify digitalis poisoning. Prompt recognition is critical to prevent worsening cardiac complications.

✅ Anorexia and nausea

🔷 Gastrointestinal disturbances are often the earliest signs of digoxin toxicity. These include loss of appetite (anorexia), nausea, vomiting, and abdominal discomfort.

🔷 Such symptoms result from digoxin’s direct action on the chemoreceptor trigger zone and GI tract, which stimulates nausea and vomiting centers.

🔷 Because these signs may appear before dangerous cardiac dysrhythmias, they are important warning indicators that the nurse must recognize quickly. Early reporting allows intervention (such as checking serum digoxin levels and adjusting dosage).

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Answer 3

Correct Answers:

Docusate sodium

Rationale :

🔷 Iron supplements commonly cause constipation because they slow intestinal motility and can harden stools. Clients often complain of abdominal discomfort and difficulty passing stool while on long-term iron therapy.

🔷 Docusate sodium is a stool softener that helps draw water into the stool, making it easier to pass and preventing painful constipation without interfering with iron absorption.

🔷 Loperamide is an antidiarrheal, which would worsen constipation.

🔷 Megestrol is an appetite stimulant, not used for bowel regulation.

🔷 Hydralazine is an antihypertensive medication and has no role in preventing constipation.

🔷 Therefore, the nurse should administer docusate sodium as the safest and most effective option for constipation prevention in a client receiving iron therapy.

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Answer 4

Correct Answers:

Donepezil

Rationale :

🔷 Donepezil is a cholinesterase inhibitor prescribed primarily for Alzheimer’s disease. It works by blocking the enzyme acetylcholinesterase, which normally breaks down acetylcholine. By inhibiting this breakdown, donepezil increases the availability of acetylcholine in the brain, supporting memory, learning, and cognitive functioning.

🔷 This helps to improve symptoms and slow progression in the early to moderate stages of Alzheimer’s, although it does not cure the disease.

🔷 The other medications listed do not work this way:

Diazepam → benzodiazepine used for anxiety, seizures, muscle spasms.

Diphenhydramine → antihistamine for allergies, causes sedation.

Dexamethasone → corticosteroid used to reduce inflammation.

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Answer 5

Correct Answers:

Human chorionic gonadotropin (HCG) test

Rationale :

🔷 Lisinopril is an ACE inhibitor used to treat hypertension and heart failure. However, it is teratogenic and contraindicated during pregnancy because it can cause fetal renal damage, oligohydramnios, growth restriction, or fetal death.

🔷 Before prescribing lisinopril to a female client of childbearing age, the nurse should ensure a negative pregnancy test (HCG test) to rule out pregnancy. This is a priority safety measure before starting therapy.

🔷 Kidney function tests are important for ongoing monitoring since lisinopril affects renal perfusion, but they are not required before every initial prescription in the same way as ruling out pregnancy.

🔷 Mammogram and liver function tests are unrelated to lisinopril therapy.

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Answer 6

Correct Answers:

Pyelonephritis

Rationale :

🔷 Ciprofloxacin is a fluoroquinolone antibiotic prescribed to treat urinary tract infections (UTIs). Stopping the medication early allows bacteria to survive and multiply, which can lead to incomplete eradication of the infection.

🔷 If untreated or partially treated, the infection can ascend from the bladder (cystitis) to the kidneys, causing pyelonephritis — a more serious infection that can result in fever, flank pain, sepsis, or permanent kidney damage.

🔷 The other conditions are unrelated:

Nystagmus → neurological/vestibular issue, not linked to antibiotic misuse.

Gastric ulcers → associated with NSAIDs or H. pylori, not incomplete antibiotic use.

DVT → clotting disorder, not related to antibiotic discontinuation.

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Answer 7

Correct Answers:

Internal and superficial bleeding

Rationale :

🔷 Thrombolytic therapy (e.g., alteplase, streptokinase) works by dissolving existing clots through the activation of plasminogen to plasmin. This systemic effect greatly increases the risk of bleeding, both internally (intracranial, gastrointestinal, retroperitoneal) and superficially (bruising, oozing at IV sites).

🔷 Bleeding is the most common and most serious adverse effect, often requiring close monitoring of vital signs, neurological status, and lab values (Hgb, Hct, coagulation profile).

🔷 While dysrhythmias can occur (especially during reperfusion in myocardial infarction), they are less common than bleeding.

🔷 Nausea/vomiting and anaphylaxis are possible but not the most frequent adverse reactions.

🔷 For safety, the nurse should frequently assess for signs of active bleeding, avoid unnecessary invasive procedures, and apply pressure to puncture sites.

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Answer 8

Correct Answers:

Liver function tests

Rationale :

🔷 Propylthiouracil (PTU) is an antithyroid medication used to manage hyperthyroidism by inhibiting thyroid hormone synthesis.

🔷 A serious adverse effect of PTU is hepatotoxicity, which can lead to liver failure. Because of this risk, clients must undergo periodic liver function tests (LFTs), especially during the first 6 months of treatment, when the risk of hepatic injury is greatest.

🔷 The nurse should educate the client to report symptoms of liver dysfunction such as jaundice, dark urine, right upper quadrant pain, or unexplained fatigue immediately.

🔷 The other tests are not relevant for PTU monitoring:

Glycosylated hemoglobin (HbA1c) → used for diabetes monitoring.

Ultrasound/CT scans → not routine for medication monitoring, only for structural thyroid evaluation if needed.

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Answer 9

Correct Answers:

The client has active hepatitis

Rationale :

💥Methotrexate is a disease-modifying antirheumatic drug (DMARD) that works by suppressing the immune system and slowing disease progression in rheumatoid arthritis.

💥It is hepatotoxic and can cause serious liver damage, especially in clients with pre-existing liver disease such as active hepatitis.

💥Clients with hepatitis or elevated liver enzymes are at increased risk of worsening hepatic injury when given methotrexate, so this condition requires extreme caution or avoidance of the medication.

💥Other factors listed (pain level, hypertension, family history of kidney disease) do not directly contraindicate methotrexate use. The key safety concern is the interaction with liver disease.

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Answer 10

Correct Answers:

Computed tomography (CT) scan with contrast dye

Rationale :

💎Metformin is contraindicated around the time of procedures that use iodinated contrast dye, such as CT scans with contrast.

💎Contrast dye can cause acute kidney injury, which reduces the clearance of metformin and increases the risk of lactic acidosis, a rare but life-threatening complication.

💎The standard precaution is to withhold metformin 24–48 hours before and after contrast procedures, and resume only once renal function is confirmed to be stable.

💎Colonoscopy, ultrasound, and plain X-ray do not involve contrast dye that would impair kidney function, so withholding metformin is unnecessary for those tests.

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QLexNursing

1 :
The nurse is preparing to administer ibuprofen to a client. To minimize the risk of gastric distress and bleeding, how should the nurse administer this medication?

2 :
The nurse is caring for a client prescribed digoxin for heart failure. The nurse is aware that which of the following are signs of digitalis toxicity? (Select all that apply.)

3 :
The client is taking iron medication for anemia. Which medication should be administered to prevent constipation?

4 :
Which of the following medications work by preventing the breakdown of acetylcholine, increasing its availability in the brain and helping to improve client symptoms?

5 :
Which action by the nurse should be performed before a female client is prescribed lisinopril?

7 :
During thrombolytic therapy, the nurse monitors the client for adverse effects. What is the most common undesirable effect of thrombolytic therapy?

8 :
The client is receiving propylthiouracil for treatment of hyperthyroidism. The nurse educates the client on the importance of having which test done periodically during the first six months of treatment?

9 :
The licensed practical nurse (LPN) is preparing to administer methotrexate to a client prescribed for rheumatoid arthritis. What factor would indicate the need for the LPN to use caution when administering this medication?

10 :
The nurse cares for a client with type 2 diabetes who takes metformin for glucose control. The client is instructed to hold their metformin medication for 48 hours prior to which diagnostic test?

QLexNursing

1 : The nurse is preparing to administer ibuprofen to a client. To minimize the risk of gastric distress and bleeding, how should the nurse administer this medication?

2 : The nurse is caring for a client prescribed digoxin for heart failure. The nurse is aware that which of the following are signs of digitalis toxicity? (Select all that apply.)

3 : The client is taking iron medication for anemia. Which medication should be administered to prevent constipation?

4 : Which of the following medications work by preventing the breakdown of acetylcholine, increasing its availability in the brain and helping to improve client symptoms?

5 : Which action by the nurse should be performed before a female client is prescribed lisinopril?

7 : During thrombolytic therapy, the nurse monitors the client for adverse effects. What is the most common undesirable effect of thrombolytic therapy?

8 : The client is receiving propylthiouracil for treatment of hyperthyroidism. The nurse educates the client on the importance of having which test done periodically during the first six months of treatment?

9 : The licensed practical nurse (LPN) is preparing to administer methotrexate to a client prescribed for rheumatoid arthritis. What factor would indicate the need for the LPN to use caution when administering this medication?

10 : The nurse cares for a client with type 2 diabetes who takes metformin for glucose control. The client is instructed to hold their metformin medication for 48 hours prior to which diagnostic test?

1 :
The nurse is preparing to administer ibuprofen to a client. To minimize the risk of gastric distress and bleeding, how should the nurse administer this medication?

2 :
The nurse is caring for a client prescribed digoxin for heart failure. The nurse is aware that which of the following are signs of digitalis toxicity? (Select all that apply.)

3 :
The client is taking iron medication for anemia. Which medication should be administered to prevent constipation?

4 :
Which of the following medications work by preventing the breakdown of acetylcholine, increasing its availability in the brain and helping to improve client symptoms?

5 :
Which action by the nurse should be performed before a female client is prescribed lisinopril?

7 :
During thrombolytic therapy, the nurse monitors the client for adverse effects. What is the most common undesirable effect of thrombolytic therapy?

8 :
The client is receiving propylthiouracil for treatment of hyperthyroidism. The nurse educates the client on the importance of having which test done periodically during the first six months of treatment?

9 :
The licensed practical nurse (LPN) is preparing to administer methotrexate to a client prescribed for rheumatoid arthritis. What factor would indicate the need for the LPN to use caution when administering this medication?

10 :
The nurse cares for a client with type 2 diabetes who takes metformin for glucose control. The client is instructed to hold their metformin medication for 48 hours prior to which diagnostic test?