A male client with diabetes mellitus takes Novolin 70/30 insulin before meals and azithromycin (Zithromax) PO daily, using medication he brought from home. When the nurse delivers his breakfast tray, the client tells the nurse that he took his insulin but forgot to take his daily dose of the Zithromax an hour before breakfast as instructed. What action should the nurse implement?

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Question 1 of 5

A male client with diabetes mellitus takes Novolin 70/30 insulin before meals and azithromycin (Zithromax) PO daily, using medication he brought from home. When the nurse delivers his breakfast tray, the client tells the nurse that he took his insulin but forgot to take his daily dose of the Zithromax an hour before breakfast as instructed. What action should the nurse implement?

Correct Answer: B

Rationale: The correct answer is B: Instruct the client to eat his breakfast and take the Zithromax two hours after eating. This is the correct action because azithromycin is best absorbed when taken on an empty stomach, but if the client has already eaten, it is recommended to wait at least 2 hours after a meal before taking it. This ensures optimal absorption and effectiveness of the medication. Choice A is incorrect because it does not address the timing issue of taking azithromycin on an empty stomach. Choice C is incorrect as skipping a dose of an antibiotic can lead to treatment failure. Choice D is incorrect as antacids can interfere with the absorption of azithromycin and should not be taken together.

Question 2 of 5

An experienced nurse tells the nurse-manager that working with a new graduate is impossible because the new graduate will not listen to suggestions. The new graduate comes to the nurse-manager describing the senior nurse's attitude as challenging and offensive. What action is best for the nurse manager to take?

Correct Answer: D

Rationale: The correct answer is D. The nurse-manager should ask the nurses to meet to identify ways of working together. This is the best action because it promotes open communication, collaboration, and conflict resolution between the two nurses. By facilitating a discussion between them, the nurse-manager can help address the underlying issues, clarify misunderstandings, and find common ground for effective teamwork. This approach encourages mutual understanding and fosters a positive working relationship. A: Having both nurses meet separately with the staff mental health consultant does not directly address the conflict between them. B: While listening actively and offering suggestions is important, involving both nurses in the discussion is crucial for resolving the conflict. C: Asking the senior nurse to examine mentoring strategies does not involve the new graduate in the conversation and may not address the overall issue.

Question 3 of 5

The nurse offers diet teaching to a female college student who was diagnosed with iron-deficiency anemia following her voluntary adoption of a lacto-vegetarian diet. What nutrients should the nurse suggest this client eat to best meet her nutritional needs while allowing her to adhere to a lacto-vegetarian diet?

Correct Answer: D

Rationale: The correct answer is D: Combine several legumes and grains such as beans and rice to form complete proteins. This is the best option because a lacto-vegetarian diet excludes meat but includes dairy products. Legumes and grains complement each other in terms of amino acid profiles, allowing the individual to obtain all essential amino acids needed for protein synthesis. This combination ensures the client gets adequate protein intake necessary for red blood cell production without consuming meat. A: Drinking whole milk instead of skim milk does not enhance amino acid production. Skim milk contains the same amino acids as whole milk. B: Taking vitamin K does not enhance red blood cell production. Iron is the key nutrient needed for red blood cell production. C: Increasing dark yellow vegetables such as carrots does not provide a significant amount of iron to fortify iron stores compared to legumes and grains.

Question 4 of 5

A client receiving amlodipine (Norvasc), a calcium channel blocker, develops 1+ pitting edema around the ankles. It is most important for the nurse to obtain what additional client data?

Correct Answer: D

Rationale: The correct answer is D (Breath sounds). Pitting edema is a common side effect of amlodipine due to vasodilation. It can also lead to pulmonary edema, causing shortness of breath and crackles on auscultation. Therefore, assessing breath sounds is crucial to detect any signs of fluid overload and potential pulmonary complications. Bladder distention (A) is not directly related to the client's current symptoms. Serum albumin level (B) may indicate protein status but is not immediately necessary in this case. Abdominal girth (C) is more indicative of ascites or abdominal distension, not directly related to the client's edema and possible pulmonary complications.

Question 5 of 5

While assessing a client who is experiencing Cheyne-Stokes respirations, the nurse observes periods of apnea. What action should the nurse implement?

Correct Answer: C

Rationale: The correct answer is C: Measure the length of the apneic periods. This action is crucial in assessing the severity of Cheyne-Stokes respirations and guiding further interventions. By measuring the length of apneic periods, the nurse can determine the duration of respiratory pauses and their impact on oxygenation. This information helps in deciding the appropriate treatment, such as administering supplemental oxygen or notifying the healthcare provider. Elevating the head of the bed (choice A) can help with breathing but does not address the root cause. Auscultating breath sounds (choice B) is important but does not directly address the apneic periods. Suctioning the oropharynx (choice D) is not indicated unless there is an airway obstruction.

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