A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?

Correct Answer: A

Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications.

Correct Answer: B

Rationale: The signs and symptoms of thyroid hormone toxicity, especially when the dosage is excessive, include tachycardia (rapid heart rate) and chest pain. These symptoms are indicative of hyperthyroidism, where the body receives an excessive amount of thyroid hormone. It is crucial to report these symptoms promptly to the healthcare provider to adjust the medication dosage and prevent potential complications.

Correct Answer: C

Rationale: Oxybutynin is prescribed to treat overactive bladder by reducing muscle spasms of the bladder. It is classified as an anticholinergic medication. Oxycodone is an opioid used for pain management. Bupropion is an antidepressant used to treat depression. Buspirone is an anxiolytic used to manage anxiety disorders.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer. The practical nurse (PN) should review with the client that their sexual partner(s) should also be treated when diagnosed with vaginal trichomoniasis and prescribed oral metronidazole. This is crucial to prevent re-infection and ensure the complete eradication of the parasite from both individuals. Option A is incorrect because while it is important to advise clients on potential side effects of medications, avoiding direct sunlight exposure and using sunscreen with SPF100 is not specifically relevant to the treatment of vaginal trichomoniasis with metronidazole. Option C is incorrect as advising against the use of vinegar or commercial product douches is a general guideline for vaginal health but not directly related to the treatment of trichomoniasis with metronidazole. Option D is incorrect as there is no need to eliminate dairy products from the diet during the treatment of vaginal trichomoniasis with metronidazole. In an educational context, it is important for practical nurses to understand the comprehensive care required for clients diagnosed with sexually transmitted infections like trichomoniasis. Educating clients on treatment protocols, including partner notification and treatment, is essential in preventing the spread of infection and promoting overall health and well-being.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B: 3:30 to 7:30 PM. NPH insulin is an intermediate-acting insulin that typically peaks around 4-12 hours after administration. Administering NPH insulin before breakfast means that its peak effect would coincide with the afternoon and early evening hours, putting the client at an increased risk for a hypoglycemic reaction during that time frame. Option A (8:30 to 11:30 AM) is incorrect because this timeframe falls shortly after the client's breakfast when the insulin's effect would not yet peak. Option C (9:30 PM to midnight) is incorrect as this timeframe is much later than when the NPH insulin would typically peak. Option D (1:00 to 5:00 AM) is also incorrect as it is too early for the peak action of NPH insulin. Educationally, this question highlights the importance of understanding the onset and peak times of different types of insulin to prevent hypoglycemic episodes in patients. Nurses should be aware of the timing of insulin administration in relation to meals to ensure optimal blood glucose control and to prevent complications such as hypoglycemia. It underscores the need for precise timing and monitoring of insulin therapy to ensure patient safety and well-being.