Nokea
A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the desired effect of this medication has been achieved?
- A. Dependent edema reduced from +3 to +1.
- B. Serum HDL increased from 35 to 55 mg/dL.
- C. Pulse rate reduced from 150 to 90 beats/min.
- D. Blood pressure reduced from 160/90 to 130/80 mm Hg.
Correct Answer: D
Rationale: The correct answer is D. Losartan is prescribed for the treatment of hypertension. The desired effect of losartan is to reduce blood pressure. Therefore, a reduction in blood pressure from 160/90 to 130/80 mm Hg indicates that the desired effect of the medication has been achieved. Choices A, B, and C are not specific effects of losartan and do not directly relate to the expected outcomes of this medication.
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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.
What instruction should the nurse include in the teaching plan for a client prescribed etanercept for rheumatoid arthritis?
- A. Rotate injection sites to prevent irritation.
- B. Take this medication with food to reduce gastrointestinal upset.
- C. Avoid sunlight exposure while on this medication.
- D. Notify the healthcare provider of any signs of infection.
Correct Answer: A
Rationale: The correct instruction for a client prescribed etanercept is to rotate injection sites to prevent irritation and ensure proper absorption. Changing sites will help prevent skin irritation and ensure that the medication is absorbed effectively. This practice also reduces the risk of injection site reactions and discomfort. It is essential to follow this instruction to promote optimal medication delivery and minimize adverse effects.
A client is prescribed nitroglycerin sublingual tablets. The practical nurse should reinforce which instruction?
- A. Store the tablets in a cool, dry place.
- B. Take one tablet every 5 minutes until pain is relieved, up to three tablets.
- C. Swallow the tablets whole.
- D. Chew the tablets for faster relief.
Correct Answer: A
Rationale: Nitroglycerin sublingual tablets are sensitive to heat and moisture, so they should be stored in a cool, dry place to maintain their efficacy. Choice B is incorrect because nitroglycerin tablets should be taken as directed by the healthcare provider. Choice C is incorrect because sublingual tablets should be placed under the tongue to dissolve, not swallowed. Choice D is incorrect because sublingual tablets should not be chewed; they are meant to be absorbed through the tissues under the tongue.
A client is prescribed lisinopril for hypertension. What potential adverse effect should the practical nurse (PN) instruct the client to monitor for?
- A. Persistent cough
- B. Constipation
- C. Increased appetite
- D. Dry skin
Correct Answer: A
Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. This cough is distinctive and different from other causes of cough. It is essential for the client to be aware of this potential side effect as it can indicate a serious issue. Instructing the client to monitor for a persistent cough and report it to the healthcare provider promptly is crucial to ensure timely intervention and management.
A client with chronic kidney disease is prescribed sevelamer carbonate. The nurse should monitor for which potential side effect?
- A. Hypercalcemia
- B. Hypocalcemia
- C. Hyperkalemia
- D. Hypokalemia
Correct Answer: A
Rationale: When a client with chronic kidney disease is prescribed sevelamer carbonate, the nurse should monitor for hypercalcemia as a potential side effect. Sevelamer carbonate can bind to dietary calcium and impair its absorption, potentially leading to elevated calcium levels in the blood. Monitoring calcium levels is crucial to detect and manage hypercalcemia promptly.