Nokea
A 59-year-old client is prescribed furosemide 40 mg twice a day for the management of heart failure. The practical nurse should monitor the client for the development of which complication?
- A. Hypokalemia
- B. Hyperchloremia
- C. Hypercalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and chloride in the kidneys, leading to increased potassium excretion and potentially causing hypokalemia. Hypokalemia can lead to cardiac irregularities, making it crucial for the practical nurse to monitor the client for this electrolyte imbalance.
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The healthcare professional is preparing client teaching materials on commonly used medications. Which client is most likely to benefit from a client education package about simvastatin?
- A. A 50-year-old male with a history of angina
- B. A 75-year-old male with bone cancer
- C. An 18-year-old pregnant female with diabetes
- D. A 40-year-old female with frequent vaginal infections
Correct Answer: A
Rationale: Simvastatin is a medication used to lower cholesterol levels and prevent cardiovascular diseases. It is commonly prescribed for individuals at risk of heart-related conditions. Angina is a symptom of underlying heart disease, and individuals with this condition would benefit most from simvastatin to help manage their cholesterol levels and reduce the risk of cardiovascular events. Therefore, the 50-year-old male with a history of angina is the most suitable candidate for client education regarding simvastatin.
A client with rheumatoid arthritis is prescribed methotrexate. The nurse should include which instruction in the client's teaching plan?
- A. Avoid alcohol while taking this medication.
- B. Take this medication with food to decrease gastrointestinal upset.
- C. Avoid sunlight while taking this medication.
- D. Report any signs of infection to the healthcare provider.
Correct Answer: C
Rationale: The correct instruction for a client prescribed methotrexate is to avoid sunlight while taking this medication. Methotrexate can increase sensitivity to sunlight, leading to skin reactions, so clients should limit sun exposure and use protective measures like sunscreen and clothing coverage to prevent adverse effects.
A client with a history of deep vein thrombosis is prescribed warfarin. The nurse should monitor for which potential adverse effect?
- A. Increased risk of bleeding
- B. Decreased risk of bleeding
- C. Increased risk of infection
- D. Decreased risk of infection
Correct Answer: A
Rationale: The correct answer is A: Increased risk of bleeding. Warfarin is an anticoagulant medication that works by prolonging the time it takes for blood to clot. Therefore, a potential adverse effect of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, nosebleeds, or blood in the urine or stool. Monitoring for these signs is essential to prevent serious complications associated with excessive bleeding.
In the immediate postoperative period, a client is prescribed morphine via a patient-controlled analgesia (PCA) pump. Which finding should the PN consider the highest priority in this client?
- A. Monitoring the expiration date of the PCA morphine
- B. Assessing the rate and depth of the client's respirations
- C. Reviewing the type of anesthesia used during the surgery
- D. Observing the client's signs of disorientation
Correct Answer: B
Rationale: The highest priority for the PN is to assess the rate and depth of the client's respirations when a client is receiving morphine via a PCA pump. Respiratory depression is a life-threatening side effect of intravenous morphine administration. If the client's respiratory rate falls below 10 breaths/min, the PCA pump should be stopped, and the healthcare provider must be notified immediately to prevent further complications.
A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?
- A. Take the medication at the same time every day.
- B. Discontinue the medication if a rash develops.
- C. Avoid consuming dairy products.
- D. Monitor blood pressure regularly.
Correct Answer: A
Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin.