Saunders Unit 4

A client who experiences allergic rhinitis asks the nurse about a nasal corticosteroid. How would the nurse reply?

"The medication works locally and decreases inflammation."

Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. The nurse would monitor for which side and adverse effects of rifabutin? Select all that apply.

1. Signs of hepatitis2. Flulike symptoms3. Low neutrophil5. Ocular pain or blurred vision

The nurse is caring for a client with an endotracheal tube attached to a mechanical ventilator. The high-pressure alarm sounds, and the nurse assesses the client. The nurse determines that the cause of the alarm is most likely to be due to which complication?

A kink in the ventilator circuit

The nurse is teaching a client about the effects of diphenhydramine, an ingredient in the cough suppressant prescribed for the client. The nurse would plan to tell the client to take which measure while taking this medication?

Avoid activities requiring mental alertness.

A client has been given a prescription for benzonatate. Which observation would the nurse look for to evaluate the effectiveness of the medication?

Calming the client's persistent cough

The nurse is caring for a client with metabolic alkalosis. The nurse plans care, knowing that most problems of metabolic alkalosis are related to increased stimulation of what systems? Select all that apply.

Cardiac Nervous Neuromuscular

A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client would be questioned about the use of which medication?

Decongestants

The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states that they will immediately report which finding?

Difficulty in discriminating the color red from green

A clinic nurse is assessing a client who has been on isoniazid for 6 months. Which client complaint would most concern the nurse?

Difficulty tying shoes

The nurse is administering a dose of pirbuterol to a client. The nurse would monitor for which side or adverse effect of this medication?

Increased pulse

The nurse is caring for a client with hyperglycemia and diabetic ketoacidosis (DKA) who now has developed Kussmaul's respirations. The nurse plans care, understanding that the purpose of this type of breathing is to correct what imbalance?

Metabolic acidosis

A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem?

Peripheral neuritis

A client with a tracheostomy tube who is on a ventilator is at risk for reduced gas exchange. The nurse would assess for which finding as the best indicator of adequate ongoing respiratory status?

Respiratory rate of 16 breaths/minute

A client diagnosed with active tuberculosis has been prescribed a combination of isoniazid and rifampin for treatment. The nurse teaches the client to perform which action?

Take both medications together once a day.

The nurse is caring for a client having respiratory distress related to an anxiety attack. Recent arterial blood gas (ABG) values are pH = 7.53, Pao2 = 72 mm Hg, Paco2 = 32 mm Hg, and HCO3- = 28 mEq/L (28 mmol/L). Which conclusion about the client would the nurse make?

The client is probably hyperventilating.

The nurse is caring for a client who is retaining carbon dioxide (CO2) as a result of an obstructive respiratory disease. The nurse plans interventions, knowing that as the client's CO2 level rises, what will occur with the blood pH?

The pH will fall

A client with suspected opioid overdose has received a dose of naloxone hydrochloride. The client subsequently becomes restless, starts to vomit, and complains of abdominal cramping. The blood pressure increases from 110/72 mm Hg to 160/86 mm Hg. The nurse provides emotional support and reassurance while administering care to the client, knowing which piece of information?

These are signs of opioid withdrawal.

A client has begun a course of therapy with rifampin. The home care nurse instructs the client on which measure due to an anticipated side effect?

Wear dark clothing to avoid staining.