MILESTONE EXAM I NEWEST ACTUAL 2024 EXAM WITH WELL DETAILED ANSWERS BY EXPERT A client with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole. Which instruction is most important for the nurse to include in this client's teaching plan? A.Avoid alcohol consumption. B.Complete the medication regimen. C.Use a barrier contraceptive method. D.Treat partner(s) concurrently. A Rationale: Clients should be instructed to avoid alcohol and products containing alcohol while taking metronidazole because of the possibility of a disulfiram-like reaction. Option B helps prevent the development of metronidazole-resistant T. vaginalis. To prevent reinfection, clients should abstain from sexual contact or use a barrier contraceptive while taking metronidazole, and their partner(s) should be treated concurrently. The Downloaded by zena ahmad (zenaahmad772@gmail.com) lOMoARcPSD|35287698 most important instruction for client well-being is option A. A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I need to take all of these medications for TB?" What information should the nurse provide? A.Antiretroviral medications decrease the efficacy of the TB drugs. B.Multiple drugs prevent the development of resistant organisms. C.Duration of the medication regimen is shortened. D.Potential adverse drug reactions are minimized. B – Rationale: A multidrug regimen is prescribed for a client with HIV and TB to prevent the development of resistance of the tubercle bacilli. Although antitubercular medications can inhibit some antiretrovirals, a multidrug regimen is needed to inhibit the proliferation of the virulent tubercle bacilli. The duration of antitubercular therapy is typically 6 to 9 months and is not shortened by the use of multiple medications. A client who is receiving HIV and TB therapy is at an increased risk of adverse reactions because of the complex medication regimens and complications secondary to immunosuppression. Downloaded by zena ahmad (zenaahmad772@gmail.com) lOMoARcPSD|35287698 Dopamine is administered to a client who is hypotensive. Which finding should the nurse identify as a therapeutic response? A.Gain in weight B.Increase in urine output C.Improved gastric motility D.Decrease in blood pressure B - Rationale: :Intropin activates dopamine receptors in the kidney and dilates blood vessels to improve renal perfusion, so an increase in urine output indicates an increase in glomerular filtration caused by increased arterial blood pressure. Option A is related to fluid retention but is not an indicator of a therapeutic response to dopamine therapy. Option C is not related to the vasopressor effect of dopamine therapy. Dopamine increases cardiac output, which increases a client's blood pressure, not option D. A 21-year-old female client is receiving tetracycline for acne. Which client teaching should the nurse include? A.Oral contraceptives may not be effective. B.Drinking cranberry juice will promote healing. C.Breast tenderness may occur as a side effect. D.The urine will turn a red-orange color. Downloaded by zena ahmad (zenaahmad772@gmail.com) lOMoARcPSD|35287698 A – Rationale: :Certain antibiotics, such as tetracycline, decrease the effectiveness of oral contraceptives. Options B, C, and D do not convey accurate information related to client teaching about this medication. An 80-year-old client who had a colon resection yesterday is receiving a constant dose of hydromorphone via a patient-controlled analgesia (PCA) pump. Which finding requires immediate nursing action? A.The client is drowsy and complains of pruritus. B.Pupils are 3 mm; PERRLA. C.The area around the sutures is reddened and swollen. D.Respirations decrease to 10 breaths/min. D - Rationale: :Hydromorphone is an opioid agonist-analgesic of opiate receptors that inhibits ascending pathways and can cause respiratory depression. Older adults are more sensitive to opioids so the "start low and go slow" approach should be taken. Option A lists common side effects of opioids, particularly the opiates, which are usually harmless and often transient