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Question 1 of 5.

An adult client has been diagnosed as having rheumatoid arthritis and is started on piroxicam (Feldene) 20 mg daily. Two days later, the client calls the nurse and says that her joints still hurt. What is the best response for the nurse to make?

A. It may take up to two weeks before results are seen with Feldene.

B. Take aspirin with the Feldene. It has an additive effect.

C. Come in to see the physician. You should have pain relief by now.

D. You may need more medication. Take one additional pill each day.

Explanation: Piroxicam, an NSAID, may take up to two weeks for full anti-inflammatory effects.

Question 2 of 5.

Which laboratory test should the nurse monitor for the client receiving the intravenous steroid Solu-Medrol?

A. Potassium level.

B. Sputum culture and sensitivity.

C. Glucose level.

D. Arterial blood gases.

Explanation: Solu-Medrol (methylprednisolone) can cause hyperglycemia, requiring glucose monitoring, especially IV. Potassium, sputum, or ABGs are less directly affected.

Question 3 of 5.

The nurse administers 18 units of Humulin N, an intermediate-acting insulin, at 1630. Which priority intervention should the nurse implement?

A. Monitor the client's hemoglobin A1c.

B. Make sure the client eats the evening meal.

C. Check the a.c. blood glucometer reading.

D. Ensure the client eats a snack.

Explanation: Humulin N peaks in 4-12 hours; evening meal prevents hypoglycemia during peak action. A1c, a.c. checks, or snacks are less immediate.

Question 4 of 5.

The nurse is administering a.m. medications. Which medication should the nurse administer first?

A. The daily digoxin to the client diagnosed with congestive heart failure.

B. The loop diuretic to the client with a serum potassium level of 3.1 mEq/L.

C. The mucosal barrier Carafate to the client diagnosed with peptic ulcer disease.

D. Solu-Medrol IVP to a client diagnosed with chronic lung disease.

Explanation: Carafate (sucralfate) forms a protective barrier and must be given on an empty stomach, 30-60 minutes before other meds, to be effective for PUD.

Question 5 of 5.

The client's vital signs are T 99.2°F, AP 59, R 20, and BP 108/72. Which medication would the nurse question administering?

A. Theo-Dur, a bronchodilator.

B. Inderal, a beta blocker.

C. Ampicillin, an antibiotic.

D. Cardizem, a calcium channel blocker.

Explanation: Inderal (propranolol) slows HR; an apical pulse of 59 warrants holding it, per guidelines, to avoid bradycardia. Other meds are unaffected by HR.

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