Question

A patient with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0800. The patient reports experiencing heartburn. The nurse brings the scheduled medications. Which action should the nurse take?

Answer 1

Correct Answers:

Administer both of the medications before breakfast as scheduled.

Rationale :

🔷 Sucralfate must be taken on an empty stomach, typically 1 hour before meals, to form a protective coating over the ulcer site and protect it from acid and pepsin.

🔷 Pantoprazole, a proton pump inhibitor, is also most effective when given before meals, as it suppresses acid production stimulated by food intake.

🔷 Giving both medications prior to breakfast ensures their intended therapeutic actions—sucralfate for mucosal protection and pantoprazole for acid suppression—are achieved.

🔷 Administering other medications like antacids simultaneously may interfere with absorption and effectiveness of sucralfate and is therefore avoided.

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Answer 2

Correct Answers:

Contact the healthcare provider.

Rationale :

🔶 Cephalexin, a cephalosporin, has a known potential for cross-reactivity with penicillin in clients with a history of anaphylaxis.

🔶 Even though the cross-allergy rate is low (about 1–4%), a history of anaphylactic reaction to penicillin warrants extreme caution.

🔶 The nurse must prioritize client safety by notifying the provider to consider an alternative antibiotic.

🔶 Administering cephalexin without prior clearance may expose the client to life-threatening allergic responses, including airway compromise and shock.

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Answer 3

Correct Answers:

Use a straw to ingest.

Rationale :

🔵 Ferrous sulfate elixir can cause permanent staining of the teeth if it comes into direct contact with enamel.

🔵 Using a straw helps bypass the teeth, directing the liquid to the back of the throat for safer swallowing.

🔵 This method preserves dental aesthetics while ensuring the patient still receives the required iron supplementation.

🔵 It is also recommended to rinse the mouth after taking the medication to further prevent discoloration.

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Answer 4

Correct Answers:

I will take the tablet every evening to control my asthma.

Rationale :

🟣 Montelukast is a leukotriene receptor antagonist used for long-term control of asthma—not for acute attacks.

🟣 It is taken once daily in the evening, as this timing helps reduce nocturnal symptoms and improve lung function overnight.

🟣 Client understanding of daily, consistent use is key for preventing chronic airway inflammation and bronchoconstriction.

🟣 Using this medication during an asthma attack would be ineffective; rescue inhalers (e.g., albuterol) are needed for immediate relief.

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Answer 5

Correct Answers:

Observe bowel movement pattern and take a stool softener.

Rationale :

🟢 Morphine, an opioid analgesic, often causes constipation due to decreased gastrointestinal motility.

🟢 Proactively using a stool softener or laxative, along with monitoring bowel patterns, is essential to prevent discomfort or impaction.

🟢 This side effect is dose-dependent and common in clients with chronic opioid therapy, such as cancer-related pain.

🟢 Addressing bowel health enhances the client's quality of life and ensures continued compliance with pain management regimens.

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Answer 6

Correct Answers:

Takes metformin hydrochloride for type 2 diabetes mellitus.

Rationale :

🔶 Metformin combined with iodinated contrast used in CT scans increases the risk of lactic acidosis, especially in clients with impaired renal function.

🔶 It is crucial to withhold metformin before and after contrast administration until renal function is confirmed as stable.

🔶 Lactic acidosis can be life-threatening and may present subtly, so risk prevention is critical during imaging procedures.

🔶 The nurse must follow up with the provider to determine if creatinine clearance has been assessed or if alternative imaging is needed.

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Answer 7

Correct Answers:

Another form of contraception is not needed.

Rationale :

🟢 St. John’s Wort is a CYP450 enzyme inducer, which reduces the effectiveness of hormonal contraceptives, such as birth control pills.

🟢 This increases the risk of unintended pregnancy, so it is essential to use a backup non-hormonal method like condoms.

🟢 The client’s statement shows a misunderstanding of the interaction, and further instruction is urgently needed.

🟢 Nurses must regularly assess for herbal supplement use, especially when patients rely on hormonal medications.

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Answer 8

Correct Answers:

Notify the healthcare provider.

Rationale :

🔵 Tremors can be a neurologic side effect of pregabalin and may indicate drug intolerance or early toxicity.

🔵 The nurse must notify the provider so the medication can be evaluated, adjusted, or discontinued if necessary.

🔵 Continuing pregabalin without addressing the symptom may increase the risk of worsening neurologic effects or client non-adherence.

🔵 Prompt communication prevents harm and ensures appropriate pharmacologic management of fibromyalgia symptoms.

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Answer 9

Correct Answers:

Be aware that difficulty sleeping and weight loss may occur.

Rationale :

🟣 Bupropion is a stimulant-like antidepressant and smoking cessation aid that can cause insomnia and appetite suppression.

🟣 These side effects are common and should be included in discharge education so the client can plan accordingly.

🟣 Clients may be advised to take it earlier in the day to reduce sleep disturbances.

🟣 Understanding side effects improves treatment adherence and encourages clients to report any issues promptly.

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Answer 10

Correct Answers:

Provides an analgesic effect for irritated bladder mucosa.

Rationale :

🟡 Phenazopyridine is a urinary tract analgesic, not an antibiotic, and works by numbing the mucosa of the bladder and urethra.

🟡 It relieves burning, urgency, and pain, especially in conditions like cystitis or after catheterization.

🟡 The client should be educated that the urine may turn orange-red, which is a harmless but expected side effect.

🟡 It is not curative; the medication should only be used short-term and in combination with antibiotics if prescribed.

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QLexNursing

1 :
A patient with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0800. The patient reports experiencing heartburn. The nurse brings the scheduled medications. Which action should the nurse take?

2 :
A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?

3 :
Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?

4 :
A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

5 :
The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

6 :
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?

7 :
A female client with mild depression reports to the nurse that she recently started taking St. John’s wort. Which information provided by the client requires further instruction?

8 :
A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?

9 :
A client with a history of smoking cigarettes for many years arrives at the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?

10 :
A client with cystitis receives a prescription for phenazopyridine. Which information should the nurse explain to the client about its therapeutic effect?

QLexNursing

1 : A patient with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0800. The patient reports experiencing heartburn. The nurse brings the scheduled medications. Which action should the nurse take?

2 : A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?

3 : Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?

4 : A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

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

6 : 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?

7 : A female client with mild depression reports to the nurse that she recently started taking St. John’s wort. Which information provided by the client requires further instruction?

8 : A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?

9 : A client with a history of smoking cigarettes for many years arrives at the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?

10 : A client with cystitis receives a prescription for phenazopyridine. Which information should the nurse explain to the client about its therapeutic effect?

1 :
A patient with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0800. The patient reports experiencing heartburn. The nurse brings the scheduled medications. Which action should the nurse take?

2 :
A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?

3 :
Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?

4 :
A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

5 :
The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

6 :
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?

7 :
A female client with mild depression reports to the nurse that she recently started taking St. John’s wort. Which information provided by the client requires further instruction?

8 :
A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?

9 :
A client with a history of smoking cigarettes for many years arrives at the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?

10 :
A client with cystitis receives a prescription for phenazopyridine. Which information should the nurse explain to the client about its therapeutic effect?