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A 55-year-old man with a 40 pack-year history of smoking develops agranulocytosis and some leukemic features. His physical examination of the heart, lungs, and abdomen are within normal limits. Should this disease relate to a potential toxic exposure, which of the following should be considered most likely?
- A. Benzene
- B. Ethylene alcohol
- C. Carbon tetrachloride
- D. Methanol
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Assessing a patient after intravenous morphine administration, the nurse notes cold, clammy skin; a pulse of 40 beats/min; respirations of 10 breaths/min; and constricted pupils. Which medication will the patient likely need next?
- A. Naloxone
- B. Meloxicam
- C. Pentazocine
- D. Propoxyphene
Correct Answer: A
Rationale: The patient's symptoms—cold, clammy skin, bradycardia, respiratory depression, and constricted pupils—are classic signs of opioid overdose. Naloxone is the antidote for opioid overdose and should be administered immediately to reverse the life-threatening effects of morphine. Meloxicam, pentazocine, and propoxyphene are not appropriate in this situation. Nurses must recognize the signs of opioid toxicity and act quickly to administer naloxone, ensuring the patient's airway, breathing, and circulation are supported.
What should you assess for in a patient who is on Valproate?
- A. Suicidal thoughts
- B. Monitor for seizures
- C. Bipolar disorder
- D. Migraines
Correct Answer: A
Rationale: The correct answer is A: Suicidal thoughts. When a patient is prescribed Valproate, it is crucial to assess for suicidal thoughts as it is a serious side effect associated with this medication. Valproate has been linked to an increased risk of suicidal ideation and behavior, particularly in patients with epilepsy or bipolar disorder. Monitoring for signs of depression or changes in behavior is essential to ensure patient safety and well-being. Choices B, C, and D are incorrect because while monitoring for seizures, managing bipolar disorder, and treating migraines are also important considerations when a patient is on Valproate, assessing for suicidal thoughts takes priority due to the serious nature of this potential side effect.
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.
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.
A healthcare professional is preparing to administer Enoxaparin to a client. Which of the following actions should the healthcare professional take?
- A. Administer the medication orally.
- B. Massage the injection site after administration.
- C. Insert the needle at a 45- to 90-degree angle.
- D. Aspirate before injecting the medication.
Correct Answer: C
Rationale: Enoxaparin should be administered subcutaneously at a 45- to 90-degree angle. This angle ensures proper delivery of the medication. Massaging the injection site should be avoided to prevent bruising and possible tissue damage. Aspiration is not required for subcutaneous injections like Enoxaparin. Therefore, the correct action for administering Enoxaparin is to insert the needle at a 45- to 90-degree angle.