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A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?
- A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
- B. Leucovorin increases platelet production and prevents bleeding.
- C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
- D. Leucovorin protects healthy cells from Methotrexate's toxic effects.
Correct Answer: D
Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment.
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A client has a prescription for hydrochlorothiazide to treat hypertension. The nurse should monitor the client for which of the following adverse effects?
- A. Hypokalemia
- B. Hypertension
- C. Hyperglycemia
- D. Hypercalcemia
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The following is most suitable for thromboembolic prophylaxis in a patient with a left ventricular aneurysm following a myocardial infarction three months ago:
- A. Intravenous heparin
- B. Subcutaneous enoxaparin
- C. Oral warfarin
- D. Oral aspirin
Correct Answer: C
Rationale: A left ventricular aneurysm post-MI risks thrombus formation due to stasis, necessitating anticoagulation. IV heparin is acute, not outpatient prophylaxis, impractical here. Subcutaneous enoxaparin prevents thromboembolism short-term (e.g., post-surgery), but its duration suits weeks, not months. Oral warfarin, a vitamin K antagonist, provides long-term anticoagulation (INR 2-3), ideal for chronic prophylaxis against mural thrombi embolizing to systemic circulation, most suitable three months post-MI. Oral aspirin (antiplatelet) or aspirin plus clopidogrel targets arterial clots, less effective for ventricular stasis-related venous thrombi. Warfarin's sustained effect reduces stroke risk, critical in this structural heart defect.
A healthcare professional is reviewing the laboratory results of a client who is taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?
- A. INR of 4.0
- B. Potassium level of 4.5 mEq/L
- C. Creatinine level of 1.0 mg/dL
- D. BUN of 18 mg/dL
Correct Answer: A
Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications.
A nurse is teaching a client who has a prescription for a long-term use of oral prednisone for chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Weight Gain
- B. Nervousness
- C. Bradycardia
- D. Constipation
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When teaching a client with a new prescription for Lithium, which instruction should the nurse include?
- A. Restrict fluid intake to 1,000 mL per day.
- B. Maintain a consistent sodium intake.
- C. Take the medication at bedtime.
- D. Expect to have frequent headaches.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.