Nokea
A client is scheduled to receive methotrexate (Folex), 0.625 mg/kg P.O. daily, to treat malignant lymphoma. Before administering the drug, the nurse reviews the client's medication history. Which of the following drugs might interact with methotrexate?
- A. digoxin (Lanoxin)
- B. Probenecid (Benemid)
- C. theophylline (Slo-Phyllin)
- D. Famotidine (Pepcid)
Correct Answer: B
Rationale: Probenecid is a drug that can interact with methotrexate by inhibiting its renal tubular secretion, leading to increased methotrexate levels and potential toxicity. It is essential to monitor the client closely for signs of methotrexate toxicity if both drugs are being used concurrently. The other options, digoxin, theophylline, and famotidine, do not have significant interactions with methotrexate that would result in increased toxicity.
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Mrs. Adams is scheduled for an intravemous pyelogram (IVP). Nurse Aura wpould be most concerned if the patient makes which of the following comments or statements?
- A. "I take Senokot (laxative) daily."
- B. "I often feel like my bladder is full even after voiding."
- C. "My whole face turns red when I eat mussels."
- D. "I experience headaches every 2 weeks."
Correct Answer: A
Rationale: Nurse Aura would be most concerned about the patient's statement regarding taking Senokot daily because laxatives can affect kidney function and urine production, which are important considerations during an intravenous pyelogram (IVP). Laxatives can lead to dehydration and electrolyte imbalances, which may affect the results and safety of the IVP procedure. It is crucial for the patient to disclose any medications or substances they are taking that could impact kidney function or urine production prior to undergoing the IVP. The other statements are not directly related to the IVP procedure or potential complications.
Reggie is a teenager suffering from osteomyelitis; the nurse would expect which of the following symptoms? Select all that apply.
- A. Fever
- B. Irritability
- C. Pallor
- D. Tenderness
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
For a client with sickle cell anemia, how does the nurse assess for jaundice?
- A. The nurse assesses mental status, verbal ability, and motor strength
- B. The nurse observes the joints for signs of swelling
- C. The nurse inspects the skin and sclera for jaundice
- D. The nurse collects a urine specimen
Correct Answer: C
Rationale: In a client with sickle cell anemia, jaundice is a common manifestation due to the breakdown of red blood cells. The nurse should inspect the skin and sclera for signs of jaundice, which presents as a yellow discoloration. This assessment helps in identifying the presence and severity of jaundice in the client, which can be indicative of ongoing hemolysis and the need for further interventions. Monitoring for jaundice is important in managing clients with sickle cell anemia to address complications early and provide appropriate care.
A nurse is assessing a child with kwashiorkor disease. Which assessment findings should the nurse expect?
- A. Thin wasted extremities with a prominent abdomen
- B. Constipation
- C. Elevated hemoglobin
- D. High levels of protein
Correct Answer: A
Rationale: Kwashiorkor is a form of severe acute malnutrition characterized by a deficiency in protein intake, leading to a protein-energy malnutrition. One of the hallmark signs of kwashiorkor is an enlarged, protruding abdomen due to fluid retention in the tissues (edema), giving the appearance of a swollen belly. Additionally, individuals with kwashiorkor often have thin, wasted extremities while their abdomen appears disproportionately distended. This is known as the "big belly, skinny limbs" presentation, which arises due to the imbalance of protein and energy intake. Therefore, the nurse assessing a child with kwashiorkor should expect to find thin wasted extremities with a prominent abdomen.
Which of the ff conditions is evident by persistent hoarseness?
- A. Bacterial infection
- B. Aphonia
- C. Laryngeal cancer
- D. Peritonsillar abscess
Correct Answer: C
Rationale: Persistent hoarseness is often a symptom of laryngeal cancer. Laryngeal cancer affects the voice box, leading to changes in voice quality, such as hoarseness. It is important to seek medical evaluation if hoarseness lasts for more than two weeks, as early detection and treatment of laryngeal cancer can improve outcomes. Bacterial infection, aphonia (loss of voice), and peritonsillar abscess are not typically associated with persistent hoarseness as a primary symptom.