Nokea
A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?
- A. Irregular heart rhythm
- B. Abnormal uterine bleeding
- C. Yellowing of the sclera or dark-colored urine
- D. Difficulty swallowing
Correct Answer: B
Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.
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A client has a new prescription for colchicine to treat gout. Which of the following instructions should be included?
- A. Take this medication with food if nausea develops.
- B. Monitor for muscle pain.
- C. Expect to have increased bruising.
- D. Increase your intake of grapefruit juice.
Correct Answer: B
Rationale: Monitoring for muscle pain is crucial when taking colchicine because it can lead to rhabdomyolysis, a serious condition characterized by muscle breakdown. This adverse effect needs prompt identification to prevent complications. Choices A, C, and D are incorrect because taking colchicine with food, experiencing increased bruising, or increasing grapefruit juice intake are not relevant instructions for a client prescribed colchicine for gout.
Which drug type is often used as a first-line treatment for depression due to its side effect profile?
- A. Monoamine oxidase inhibitors (MAOIs)
- B. Beta-adrenergic blockers
- C. Tricyclic antidepressants (TCAs)
- D. Selective serotonin reuptake inhibitors (SSRIs)
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client?
- A. Please come into the clinic immediately to have a pregnancy test done.'
- B. You might consider another form of birth control if you keep missing your pills.'
- C. If you have missed fewer than three of your pills, you do not need to worry.'
- D. You should use an alternative form of birth control for the rest of this cycle.'
Correct Answer: D
Rationale: Missing several contraceptive pills compromises efficacy, requiring an alternative method for the cycle to prevent pregnancy. Testing assesses outcome, not prevention. Future methods don't address now. Fewer than three still risks failure. D ensures immediate protection, making it the best instruction.
A client has a new prescription for Hydralazine. Which of the following side effects should the nurse instruct the client to monitor for and report?
- A. Orthostatic hypotension
- B. Increased heart rate
- C. Dark-colored urine
- D. Persistent cough
Correct Answer: B
Rationale: Corrected Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia, leading to an increased heart rate. This side effect should be reported to the healthcare provider to ensure appropriate management and monitoring of the client's condition. Choice A (Orthostatic hypotension) is incorrect as Hydralazine is more likely to cause reflex tachycardia than orthostatic hypotension. Choice C (Dark-colored urine) and Choice D (Persistent cough) are unrelated to the common side effects of Hydralazine and should not be the focus of monitoring for this medication.
What should you monitor when administering Clopidogrel to a patient?
- A. Signs of thrombotic thrombocytopenic purpura
- B. Bleeding during therapy
- C. CBC with differential and platelet count
- D. All of the above
Correct Answer: D
Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.