Question

A 47yr old female patient is prescribed cimetidine PO for peptic ulcer disease. The nurse would include which of the following when providing education about this medication? Select the three correct answers.

Answer 1

Correct Answers:

Take this medication 30 minutes before or after meals.
Do not take this medication with oral antacids.
This medication can cause dysrhythmias and pneumonia.

Rationale :

🔹 Cimetidine should be taken 30 minutes before or after meals because food can reduce the drug’s absorption and delay its onset of action.

🔹 Avoiding antacids is essential because antacids decrease the absorption of cimetidine by altering gastric pH.

🔹 Cimetidine can cause dysrhythmias and pneumonia, especially in older adults or critically ill patients due to altered gastric flora and CNS effects.

🔹 This medication suppresses gastric acid, so teaching must emphasize monitoring for respiratory infections that can develop due to decreased acid-mediated bacterial defense.

🔹 Cimetidine crosses the blood–brain barrier, so cardiac and pulmonary adverse effects are well documented and must be included in patient education.

Check sodium levels before administration

🔹 Cimetidine does not affect sodium levels or fluid–electrolyte balance.

🔹 Sodium monitoring is not part of the safety requirements for this drug.

Take this medication with meals

🔹 Taking with meals decreases absorption and effectiveness.

🔹 Timing with meals may delay symptom control for peptic ulcer disease.

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Answer 2

Correct Answers:

Epinephrine (Adrenalin) drip

Rationale :

⭐ Cardiogenic shock presents with low cardiac output and high PAWP, indicating the heart cannot pump effectively.

⭐ Epinephrine improves contractility (α1 and β1 effects), helping restore forward blood flow.

⭐ It increases systemic vascular resistance, supporting blood pressure when the myocardium is failing.

⭐ It raises heart rate and enhances myocardial perfusion, essential in a failing pump.

⭐ Epinephrine is indicated in severe hypotension and cardiogenic collapse when inotropes are required.

Hydrocortisone

⭐ Steroids support adrenal insufficiency—not cardiogenic shock.

⭐ They do not improve contractility or cardiac output.

Furosemide

⭐ Although used when pulmonary congestion exists, the patient already has low cardiac output, not fluid overload.

⭐ Diuretics would worsen hypotension and perfusion.

Albumin 5%

⭐ Volume expansion is not appropriate because PAWP is already elevated.

⭐ More fluid would worsen pulmonary edema.

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Answer 3

Correct Answers:

sardines and liver.

Rationale :

🔸 Purines metabolize into uric acid, increasing risk of uric-acid stones.

🔸 Organ meats and oily fish are the highest natural purine sources.

🔸 Reducing purine intake is first-line prevention for uric acid calculi recurrence.

🔸 Lower uric acid levels decrease stone formation by reducing supersaturation in the kidneys.

🔸 Patients with previous uric acid stones require strict dietary adjustment to prevent further crystallization.

Spinach, chocolate, tea

🔸 These relate more to oxalate stones, not uric-acid stones.

🔸 They do not contain high levels of purines.

Milk and cheese

🔸 Dairy products are low-purine foods.

🔸 These are often encouraged to help dilute acidic urine.

Legumes and dried fruit

🔸 These foods contain moderate purines but are not the major culprits.

🔸 They are not primary restrictions for uric-acid stones.

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Answer 4

Correct Answers:

blood potassium level of 2.8 mEq/L

Rationale :

🟡 Furosemide causes potassium loss, and 2.8 mEq/L is a medical emergency.

🟡 Severe hypokalemia can trigger lethal dysrhythmias, especially in hypertensive or cardiac patients.

🟡 This level requires immediate replacement, often IV if symptomatic.

🟡 Symptoms such as muscle weakness, arrhythmias, and hypotension can occur quickly at this level.

🟡 This electrolyte imbalance is life-threatening and takes priority over blood pressure changes.

12 mmHg orthostatic drop

🟡 Mild orthostatic hypotension is expected with diuretics and not emergent.

🟡Magnesium 1.8

🟡 This is within normal limits and does not require rapid action.

🟡BP 164/102

🟡 Elevated BP is important but does not pose immediate fatal risk compared to hypokalemia.

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Answer 5

Correct Answers:

"Do you find it difficult to control your worrying?"

Rationale :

🔹 Generalized Anxiety Disorder (GAD) is defined by excessive, uncontrollable worry, so assessing the ability to control worry directly targets the diagnostic feature.

🔹 GAD symptoms must be present for at least 6 months, and asking about worry control helps determine duration and persistence.

🔹 The question is open-ended, promoting therapeutic communication and detailed assessment without leading the patient.

🔹 Difficulty controlling worry causes impairment in daily functioning, so this question reveals the degree of disruption.

🔹 Screening for uncontrollable worry guides further assessment, such as sleep disturbance, restlessness, and irritability.

🔹“Do you feel uncomfortable in social situations?”

🔹 This evaluates social anxiety disorder, not GAD.

🔹 It focuses on social fear, which is not the hallmark of GAD.

🔹 “Do you repeatedly do certain things over and over again?”

🔹 This suggests obsessive-compulsive disorder (OCD) behaviors.

🔹 Repetitive rituals are not part of GAD symptom criteria.

🔹“Have you been a victim of a crime or seen someone injured?”

🔹 This screens for PTSD, not GAD.

🔹 Trauma exposure must be established before PTSD assessment.

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Answer 6

Correct Answers:

Angioedema and pruritis
Chest tightness and wheezing
Hypotension and tachycardia
Nausea and stomach cramps

Rationale :

⭐ Angioedema and pruritis occur due to massive histamine release during anaphylaxis.

⭐ Chest tightness and wheezing occur from bronchoconstriction and airway narrowing.

⭐ Hypotension and tachycardia result from vasodilation and fluid shift into tissues.

⭐ Nausea and stomach cramps occur when smooth muscles in the GI tract react to histamine and inflammatory mediators.

⭐ Anaphylaxis affects multiple organ systems simultaneously, so respiratory, skin, cardiovascular, and GI symptoms are expected.

Paresthesia and paralysis

⭐ These signs indicate neurologic conditions, not anaphylaxis.

⭐ Paralysis is not part of the acute systemic allergic response.

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Answer 7

Correct Answers:

Oxygen saturation

Rationale :

🔶 Airway and breathing are the highest priority in anaphylaxis, making oxygenation status essential.

🔶 Oxygen saturation directly shows the effectiveness of airway treatment after epinephrine and bronchodilators.

🔶 Hypoxia kills within minutes, so continuous monitoring is required.

🔶 SpO₂ indicates whether airway swelling is resolving, especially after epinephrine administration.

🔶 Other vital signs may improve later, but oxygenation improvement reflects true stabilization.

Orientation

🔶 Mental status changes occur late and reflect severe hypoxia, not early recovery.

🔶 It is not a primary indicator of treatment response in anaphylaxis.

Heart rate

🔶 Tachycardia can persist due to epinephrine, anxiety, or hypoperfusion.

🔶 Heart rate does not reliably indicate successful airway management.

Blood pressure

🔶 BP may remain unstable even when airway improves.

🔶 Vasodilation takes time to correct after epinephrine.

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Answer 8

Correct Answers:

Respiratory Acidosis, partially compensated

Rationale :

🟣 Low pH (7.32) indicates acidosis.

🟣 High PaCO₂ (48) shows CO₂ retention, the hallmark of respiratory acidosis.

🟣 High HCO₃ (30) indicates the kidneys are compensating, but compensation is not complete because the pH is still acidic.

🟣 This pattern often occurs in hypoventilation, seen post-operatively from shallow breathing and pain.

🟣 The patient symptoms (dizziness, SOB, headache) match rising CO₂ levels.

Respiratory alkalosis

🟣 This would require low CO₂, not high.

🟣 pH would be >7.45, not acidic.

Metabolic acidosis

🟣 HCO₃ would be low, not elevated.

🟣 CO₂ would not be the primary abnormality.

Respiratory acidosis, uncompensated

🟣 HCO₃ is elevated, showing kidney compensation has started.

🟣 Uncompensated disorders have normal HCO₃.

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Answer 9

Correct Answers:

Dish of lemon gelatin

Rationale :

💛 Clear liquids are recommended first after N/V, and gelatin is an ideal gentle option.

💛 It reduces gastric stimulation, lowering the risk of recurrent vomiting.

💛 Gelatin is easy to digest and does not irritate the mucosa.

💛 It helps reintroduce oral intake slowly, preventing nausea from returning.

💛 It avoids fat, acid, and heat, all of which worsen gastrointestinal upset.

Hot chicken broth

💛 Heat and fat stimulate the GI tract and increase nausea.

💛 Warm broth may worsen gastric irritation.

Orange juice

💛 Highly acidic and irritates the stomach.

💛 Can trigger more vomiting.

Coffee with cream

💛 Caffeine increases gastric acid production.

💛 Cream adds fat, which delays gastric emptying.

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Answer 10

Correct Answers:

Stabilization of the patient

Rationale :

🔷 The immediate goal in acute psychological crisis is stabilization, meaning reducing anxiety to a manageable level.

🔷 The patient is hysterical and acutely distressed, so the priority is to restore emotional and physiological safety before any long-term goals.

🔷 Crisis theory emphasizes safety, grounding, and stabilization first, because the patient cannot process information while overwhelmed.

🔷 Stabilizing anxiety allows the nurse to prevent harmful behaviors, such as panic-driven actions or dissociation.

🔷 All other goals (wellness, recovery, remission) come later, after acute stabilization is achieved.

Optimal wellness

🔷 This is a long-term preventive goal, not appropriate for a client in acute crisis.

🔷 The patient must first be stabilized before any wellness planning.

Remission of the illness

🔷 Remission applies to chronic psychiatric illness, not acute situational crisis.

🔷 This goal does not address the patient’s immediate emotional instability.

Complete recovery

🔷 Recovery is a long-term outcome, not an immediate goal during active hysteria.

🔷 Crisis intervention prioritizes short-term stabilization, not long-term cure.

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QLexNursing

1 :
A 47yr old female patient is prescribed cimetidine PO for peptic ulcer disease. The nurse would include which of the following when providing education about this medication? Select the three correct answers.

2 :
A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128, respirations 28. The pulmonary artery wedge pressure (PAWP) is increased and cardiac output is low. The nurse will anticipate an order for which medication?

3 :
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to limit foods high in purines. Which of the following foods should be limited?

4 :
The nurse is evaluating the response to treatment for a patient that has recently started taking furosemide to treat stage 2 hypertension. Which clinical findings will require the nurse to act most rapidly?

5 :
A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which question would be most appropriate for the nurse to ask?

6 :
The emergency department nurse is caring for a patient with a suspected anaphylactic reaction to peanuts. What are the 4 (four) possible clinical manifestations of anaphylactic shock? Select the four correct answers.

7 :
Which assessment information is most important for the nurse to obtain when evaluating whether treatment of a patient with anaphylactic shock has been effective?

8 :
A patient on the Med-Surg floor who recently had abdominal surgery is now complaining of dizziness, shortness of breath, headache and a racing heart. How should the nurse interpret the following arterial blood gas results: pH 7.32, PaO2 87 mm Hg, PaCO2 48 mm Hg, and HCO3 30 mEq/L?

9 :
Which item should the nurse offer to the patient restarting oral intake after being NPO due to nausea and vomiting?

10 :
A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening. What is the most immediate nursing goal for this patient?

QLexNursing

1 : A 47yr old female patient is prescribed cimetidine PO for peptic ulcer disease. The nurse would include which of the following when providing education about this medication? Select the three correct answers.

2 : A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128, respirations 28. The pulmonary artery wedge pressure (PAWP) is increased and cardiac output is low. The nurse will anticipate an order for which medication?

3 : To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to limit foods high in purines. Which of the following foods should be limited?

4 : The nurse is evaluating the response to treatment for a patient that has recently started taking furosemide to treat stage 2 hypertension. Which clinical findings will require the nurse to act most rapidly?

5 : A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which question would be most appropriate for the nurse to ask?

6 : The emergency department nurse is caring for a patient with a suspected anaphylactic reaction to peanuts. What are the 4 (four) possible clinical manifestations of anaphylactic shock? Select the four correct answers.

7 : Which assessment information is most important for the nurse to obtain when evaluating whether treatment of a patient with anaphylactic shock has been effective?

8 : A patient on the Med-Surg floor who recently had abdominal surgery is now complaining of dizziness, shortness of breath, headache and a racing heart. How should the nurse interpret the following arterial blood gas results: pH 7.32, PaO2 87 mm Hg, PaCO2 48 mm Hg, and HCO3 30 mEq/L?

9 : Which item should the nurse offer to the patient restarting oral intake after being NPO due to nausea and vomiting?

10 : A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening. What is the most immediate nursing goal for this patient?

1 :
A 47yr old female patient is prescribed cimetidine PO for peptic ulcer disease. The nurse would include which of the following when providing education about this medication? Select the three correct answers.

2 :
A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128, respirations 28. The pulmonary artery wedge pressure (PAWP) is increased and cardiac output is low. The nurse will anticipate an order for which medication?

3 :
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to limit foods high in purines. Which of the following foods should be limited?

4 :
The nurse is evaluating the response to treatment for a patient that has recently started taking furosemide to treat stage 2 hypertension. Which clinical findings will require the nurse to act most rapidly?

5 :
A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which question would be most appropriate for the nurse to ask?

6 :
The emergency department nurse is caring for a patient with a suspected anaphylactic reaction to peanuts. What are the 4 (four) possible clinical manifestations of anaphylactic shock? Select the four correct answers.

7 :
Which assessment information is most important for the nurse to obtain when evaluating whether treatment of a patient with anaphylactic shock has been effective?

8 :
A patient on the Med-Surg floor who recently had abdominal surgery is now complaining of dizziness, shortness of breath, headache and a racing heart. How should the nurse interpret the following arterial blood gas results: pH 7.32, PaO2 87 mm Hg, PaCO2 48 mm Hg, and HCO3 30 mEq/L?

9 :
Which item should the nurse offer to the patient restarting oral intake after being NPO due to nausea and vomiting?

10 :
A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening. What is the most immediate nursing goal for this patient?