A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very

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Question 1 of 5

A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very

Correct Answer: A

Rationale: The nurse will know that it is important to teach the patient to take extra precautions when standing up because of the potential risk of orthostatic hypotension and falls while taking a diuretic for hypertension. Orthostatic hypotension is a common side effect of diuretics, which can lead to dizziness or lightheadedness when changing positions, particularly when standing up quickly. This can increase the risk of falls and injury, especially in elderly patients like this 79-year-old individual. Therefore, the teaching point about taking extra precautions while standing up is crucial for the safety and well-being of the patient.

Question 2 of 5

A patient has been diagnosed has having 'long QT syndrome.' The patient is experiencing significant pain following a bout with shingles. What would be an appropriate drug for his pain?

Correct Answer: D

Rationale: Long QT syndrome predisposes patients to torsades de pointes, so pain management must avoid QT-prolonging drugs. Amitriptyline, a TCA, extends QT via sodium channel blockade, risking arrhythmias. Fentanyl, an opioid, has minimal QT impact and relieves severe pain but carries respiratory depression risks, less ideal for shingles' neuropathic pain. Acyclovir treats shingles' viral cause, not pain directly. Diazepam addresses anxiety, not pain. Gabapentin, an anticonvulsant, targets neuropathic pain (common in postherpetic neuralgia) by modulating calcium channels, with no significant QT prolongation, making it safe and effective here. Its efficacy in nerve pain, lack of cardiac risk, and suitability for chronic management post-shingles distinguish it as the best option.

Question 3 of 5

The patient was receiving haloperidol (Haldol), a dopamine antagonist. The psychiatrist changed the order to aripiprazole (Abilify), a partial dopamine antagonist. Which statement best describes the effect of the change of medication on the patient?

Correct Answer: D

Rationale: Aripiprazole, a partial dopamine agonist, balances receptor activity versus haloperidol's full block, reducing side effects like extrapyramidal symptoms, common in schizophrenia treatment. Compliance isn't directly tied to this switch. Efficacy or symptom reduction varies-side effect profile drives the change. Fewer side effects align with aripiprazole's design, improving tolerability.

Question 4 of 5

A client with juvenile pilocytic astrocytoma who is receiving dexamethasone (Decadron) 4mg/IV

Correct Answer: D

Rationale: Juvenile pilocytic astrocytoma is a type of brain tumor that can cause neurological symptoms such as changes in cognition and personality. A sudden change in the client no longer recognizing a family member could indicate a worsening of the tumor or potential complications from the treatment with dexamethasone. This change in cognition should raise immediate concern for the nurse as it may signal a decline in the client's neurological status requiring prompt assessment and intervention. The other options are also important to monitor, but the change in cognition is the most concerning as it suggests a more immediate and potentially serious issue.

Question 5 of 5

A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very

Correct Answer: A

Rationale: The nurse will know that it is important to teach the patient to take extra precautions when standing up because of the potential risk of orthostatic hypotension and falls while taking a diuretic for hypertension. Orthostatic hypotension is a common side effect of diuretics, which can lead to dizziness or lightheadedness when changing positions, particularly when standing up quickly. This can increase the risk of falls and injury, especially in elderly patients like this 79-year-old individual. Therefore, the teaching point about taking extra precautions while standing up is crucial for the safety and well-being of the patient.

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