A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin.
Which of the following information should the nurse include in the teaching?

Plan to self-administer this medication for the next 6 months.

Administer the medication into one nostril once per week.

Lie down for 1 hour after administering the medication.

Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.

Answer and Explanation

The Correct Answer is B

This is the recommended dosage for cyanocobalamin nasal spray for pernicious anaemia and vitamin B12 deficiency. Cyanocobalamin nasal gel is used to prevent a lack of vitamin B12 that may be caused by various factors.

Choice A is wrong because the duration of treatment depends on the individual’s response and blood levels of vitamin B. Some people may need to use this medication for longer than 6 months.

Choice C is wrong because there is no need to lie down for 1 hour after administering the medication.

This may cause nasal irritation or drainage.

Choice D is wrong because using a nasal decongestant 15 minutes before the medication may interfere with the absorption of cyanocobalamin. If you have a stuffy nose, you should talk to your doctor about alternative ways to take vitamin B.

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Correct Answer is C

Explanation

Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.

Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.

Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.

Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.

COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.

A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.

A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.

A. Rinse your child’s mouth following administration. B. A spacer will make it easier to use the device. C. Soak the inhaler in water after use. D. Have your child take one inhalation as needed for shortness of breath. E. Shake the device prior to administration.

Correct Answer is ["A","B"]

Explanation

Fluticasone is an inhaled steroid that prevents the symptoms of asthma by decreasing inflammation in the airways. It is not used to treat a sudden asthma attack.

Some additional information to explain why the other choices are wrong are:

Choice C is wrong because soaking the inhaler in water after use can damage the device and affect its performance.

Choice D is wrong because fluticasone is not a rescue inhaler that can be used as needed for shortness of breath.It is a controller inhaler that should be used regularly as prescribed by the doctor.

Choice E is wrong because shaking the device prior to administration is not necessary for a fluticasone metered-dose inhaler (MDI).However, it is recommended for fluticasone inhalation powder (Flovent Diskus). Some normal ranges that may be applicable are:

The usual dose of fluticasone MDI for adults and children 12 years and older is 55 to 232 mcg twice a day.The usual dose of fluticasone MDI for children 4 to 11 years old is 30 mcg twice a day. The maximum dose of fluticasone MDI for adults and children 12 years and older is 1000 mcg twice a day.

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A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Correct Answer is C

Explanation

A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler. Which of the following information should the nurse include in the teaching? (Select all that apply)

Correct Answer is ["A","B"]

Explanation

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A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin.
Which of the following information should the nurse include in the teaching?