A nurse is preparing to insert a miconazole vaginal suppository for a client who has vulvovaginal candidiasis. Which of the following actions is appropriate for inserting this medication?

Assist the client to a left lateral position.

Insert the suppository along the posterior wall of the vaginal canal

Apply a light coating of petroleum jelly to the suppository.

Put on sterile gloves before handling the suppository.

Answer and Explanation

The Correct Answer is B

A. Assist the client to a left lateral position. The preferred position for vaginal suppository insertion is the dorsal recumbent (lying on the back with knees bent) or the lithotomy position. The left lateral position is typically used for rectal suppository administration, not vaginal medication insertion.

B. Insert the suppository along the posterior wall of the vaginal canal. The suppository should be inserted along the posterior vaginal wall, as this allows for proper absorption and helps ensure the medication remains in place. The client should be advised to lie down for at least 10-15 minutes after insertion to prevent the suppository from slipping out.

C. Apply a light coating of petroleum jelly to the suppository. Petroleum jelly should never be used as it can interfere with medication absorption and may break down the suppository. If lubrication is needed, a small amount of water-soluble lubricant (e.g., KY Jelly) can be applied to facilitate insertion.

D. Put on sterile gloves before handling the suppository. Clean gloves (not sterile gloves) are sufficient for vaginal suppository administration. The vaginal canal is not a sterile environment, so strict aseptic technique is not required. However, proper hand hygiene and glove use are essential to prevent contamination and infection.

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Correct Answer is B

Explanation

A. Varenicline. Varenicline is used to aid smoking cessation by reducing nicotine cravings and withdrawal symptoms. It does not have a role in managing acute alcohol withdrawal and would not be effective in preventing withdrawal-related complications.

B. Diazepam. Diazepam, a benzodiazepine, is commonly used to manage acute alcohol withdrawal by preventing seizures, reducing agitation, and alleviating autonomic hyperactivity (e.g., tachycardia, hypertension). It enhances GABA activity, which helps counteract the excitatory effects of alcohol withdrawal, reducing the risk of delirium tremens (DTs).

C. Clonidine. Clonidine is an alpha-2 agonist that helps control autonomic symptoms such as elevated blood pressure and heart rate. While it may be used as an adjunct therapy, it does not prevent seizures or delirium, making it insufficient as a primary treatment for alcohol withdrawal.

D. Methadone. Methadone is used for opioid withdrawal and maintenance therapy in opioid dependence. It does not alleviate alcohol withdrawal symptoms or prevent complications such as seizures or delirium, making it inappropriate for this condition.

A. Mependine B. Diazepam C. Naloxone D. Promethazine

Correct Answer is D

Explanation

A. Meperidine. Meperidine is an opioid analgesic used for moderate to severe pain. It does not treat nausea and vomiting and can worsen these symptoms by delaying gastric emptying. Opioids also depress the central nervous system, which may cause dizziness and sedation.

B. Diazepam. Diazepam is a benzodiazepine used for anxiety, muscle spasms, and seizures. It has no antiemetic effects and does not relieve nausea or vomiting. Instead, it can cause dizziness and drowsiness, which may further discomfort the client.

C. Naloxone. Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression. Since the client’s nausea is not opioid-related, naloxone would not be beneficial. Its administration can also cause withdrawal symptoms in opioid-dependent clients.

D. Promethazine. Promethazine is an antiemetic that blocks histamine and dopamine receptors in the brain, reducing nausea and vomiting. It is commonly used for motion sickness, post-surgical nausea, and gastrointestinal illnesses, making it the appropriate choice for this client.

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A nurse is preparing to insert a miconazole vaginal suppository for a client who has vulvovaginal candidiasis. Which of the following actions is appropriate for inserting this medication?

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