Nokea
An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?
- A. Tremors
- B. Dizziness
- C. Confusion
- D. Hallucinations
Correct Answer: C
Rationale: Older clients are particularly vulnerable to central nervous system side effects of cimetidine. The most frequent side effect is confusion. It is crucial for nurses to be vigilant in monitoring for confusion as it can impact the client's safety and well-being. While tremors, dizziness, and hallucinations are possible side effects, confusion is the most common in older clients taking cimetidine.
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The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:
- A. Immediately before swimming
- B. 15 minutes before exposure to the sun
- C. Immediately before exposure to the sun
- D. At least 30 minutes before exposure to the sun
Correct Answer: D
Rationale: Chemical sunscreens are most effective when applied at least 30 minutes before exposure to the sun to allow them to penetrate the skin and provide optimal protection. Applying sunscreen in advance ensures it has enough time to be absorbed and offer the intended protection. It is important to reapply sunscreen after swimming or sweating to maintain its effectiveness.
The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?
- A. Fever
- B. Diarrhea
- C. Complaints of nausea and vomiting
- D. Crackles on auscultation of the lungs
Correct Answer: D
Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications.
Before initiating a client with tuberculosis on anti-tuberculosis therapy with isoniazid (INH), a nurse ensures that which of the following baseline studies has been completed?
- A. Electrolyte levels
- B. Coagulation times
- C. Liver enzyme levels
- D. Serum creatinine level
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The healthcare provider prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. What is the appropriate intervention for the nurse?
- A. Administer the medication within 60 minutes before the morning and evening meal.
- B. Withhold the medication and question the prescription with the healthcare provider.
- C. Monitor the client for gastrointestinal side effects after administration of the medication.
- D. Withdraw the insulin from the Penlet into an insulin syringe to prepare for administration.
Correct Answer: B
Rationale: Exenatide (Byetta) is specifically indicated for the treatment of type 2 diabetes mellitus and is not recommended for clients with type 1 diabetes mellitus who are taking insulin. Therefore, the appropriate intervention for the nurse is to withhold the medication and question the prescription with the healthcare provider to ensure the safety and appropriateness of the treatment plan for the client.
A client is learning how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?
- A. Withdraws the NPH insulin first
- B. Withdraws the regular insulin first
- C. Injects air into the NPH insulin vial first
- D. Injects an amount of air equal to the desired dose of insulin into the vial
Correct Answer: A
Rationale: When mixing regular insulin with another insulin preparation, it is crucial to withdraw the regular insulin first to prevent contamination. NPH insulin should be drawn after the regular insulin to maintain the integrity of each insulin type. Therefore, if the client withdraws the NPH insulin first, it indicates the need for further teaching.