A patient with a history of peptic ulcer disease is prescribed famotidine (Pepcid) for gastric acid suppression. Which instruction should the nurse include in patient education about famotidine therapy?

Correct Answer: B

Rationale: Famotidine belongs to a class of medications known as H2 blockers which work to reduce the production of stomach acid. Antacids, on the other hand, work by neutralizing stomach acid. Taking antacids in conjunction with famotidine can decrease the effectiveness of famotidine as they can interfere with its absorption. Therefore, it is important for the patient to avoid taking antacids while on famotidine therapy to ensure optimal treatment outcomes for gastric acid suppression.

Correct Answer: A

Rationale: The response indicating Annie's present condition would be option A. This is because the symptoms mentioned in option A, such as experiencing vertigo, nausea, and nystagmus when sitting, point towards a vestibular disorder. These are symptoms commonly associated with conditions like Meniere's disease or vestibular neuritis, which can cause balance issues and feelings of dizziness. These symptoms are more indicative of Annie's current health status compared to the other options which focus on past or unrelated issues, such as ear pain during travel or impaired hearing since birth. The information provided in option A gives a more direct insight into Annie's present condition, making it the most appropriate response.

Correct Answer: B

Rationale: The first step that a nurse must keep in mind to start a nursing improvement project is to determine the nursing standards. This is crucial because nursing standards provide guidelines and benchmarks for quality care delivery. By identifying and understanding the established standards, nurses can assess current practices, identify areas that need improvement, and develop strategies to enhance patient care. Setting a clear foundation based on nursing standards is essential before moving forward with implementing corrective actions, determining findings for correction, or collecting data. Understanding and aligning with nursing standards from the outset ensures that the improvement project is focused on promoting best practices and achieving positive outcomes for patients.

Correct Answer: B

Rationale: In a patient experiencing an acute asthma exacerbation with severe respiratory distress and hypoxemia, the most appropriate intervention is to initiate non-invasive positive pressure ventilation (NIPPV). NIPPV can help improve ventilation, decrease work of breathing, and correct hypoxemia by providing positive pressure to keep the airways open, reduce air trapping, and increase the elimination of carbon dioxide. This intervention can help improve oxygenation and reduce the need for invasive mechanical ventilation in patients with severe asthma exacerbations. Administering high-flow oxygen via nasal cannula alone may not provide enough support for patients with severe respiratory distress. Nebulized albuterol/ipratropium combination therapy and intravenous corticosteroid therapy are also important treatments for asthma exacerbations but are not the first-line interventions for patients with severe respiratory distress and hypoxemia.

Correct Answer: D

Rationale: The Somogyi effect, also known as rebound hyperglycemia, is a phenomenon observed in patients with diabetes mellitus during sleep. It is characterized by a low blood sugar level (hypoglycemia) followed by high blood sugar (hyperglycemia) in the morning. This occurs due to limited insulin in the body during the night, leading to high blood sugar levels in the morning as a response to the hypoglycemia episode. Too much globulin or albumin are not directly associated with the Somogyi effect. Increasing insulin in the body would rather help prevent the hypoglycemia episode that triggers the rebound hyperglycemia in the Somogyi effect.

Correct Answer: C

Rationale: Progesterone in oral contraceptives works primarily by inhibiting ovulation. It suppresses the secretion of luteinizing hormone (LH) from the pituitary gland, which is essential for triggering the release of an egg (ovulation) from the ovary. By blocking ovulation, progesterone helps prevent pregnancy by making it less likely for a mature egg to be available for fertilization. This mechanism of action is a key factor in the effectiveness of progesterone-containing contraceptives in preventing pregnancy.

Correct Answer: C

Rationale: Periodontitis is the dental condition characterized by inflammation and destruction of the supporting structures of the teeth, including the gingiva (gums), periodontal ligament, and alveolar bone. It is usually caused by untreated gingivitis, where plaque buildup along the gumline leads to bacterial infection and inflammation, resulting in destruction of the tissues that support the teeth. If left untreated, periodontitis can lead to tooth loss and other complications. Gingivitis, on the other hand, is inflammation of the gums without involvement of the supporting structures, while dental caries refer to tooth decay or cavities in the enamel. Dental abscess is a localized collection of pus caused by a bacterial infection.

Correct Answer: D

Rationale: The large intestine, also known as the colon, is responsible for absorbing water and electrolytes from undigested food residue that passes through the digestive system after it has been processed in the small intestine. As the waste material moves through the colon, water is absorbed, and the remaining material forms feces. The feces are then stored until they are eliminated from the body through the rectum and anus. The liver, stomach, and pancreas play important roles in digestion and nutrient absorption, but the specific function of absorbing water and forming feces is carried out by the large intestine.

Correct Answer: A

Rationale: The appropriate action for a nurse in this situation is to request the senior nurse to read the illegible order for clarification. It is essential to ensure accurate and safe patient care by confirming the correct interpretation of the order with a colleague familiar with the handwriting. This action helps prevent errors and misunderstandings that may occur due to illegible handwriting. Consulting with the senior nurse is a common practice in healthcare settings to maintain effective communication and avoid mistakes in patient care.