Nokea
A client is prescribed with carbamazepine (Tegretol) for the treatment of bipolar disorder. Which of the following laboratory results indicates that the client is experiencing a side effect of this medication?
- A. Neutrophil count of 1,200/mm3.
- B. Platelet count of 160,000/mm3.
- C. Uric acid level of 4mg/dl.
- D. SGPT (ALT) level 50 units per liter of serum.
Correct Answer: A
Rationale: Carbamazepine can cause leukopenia, including neutropenia, as a side effect. A neutrophil count of 1,200/mm3 is below the normal range and indicates a potential adverse effect. Platelet count, uric acid, and SGPT levels are within normal ranges and do not indicate side effects. Therefore, the neutrophil count is the concerning result.
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A client with heart failure is prescribed digoxin. Which of the following findings should the nurse identify as an adverse effect of digoxin?
- A. Constipation
- B. Blurred vision
- C. Nausea
- D. Headache
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 34-year-old man is a chronic alcoholic and is in and out of a rehabilitation center on a monthly basis. His physician administers a blocker of aldehyde dehydrogenase. Which of the following effects is most likely to be exhibited by this patient following administration?
- A. Bradycardia
- B. Elation
- C. Euphoria
- D. Nausea
Correct Answer: D
Rationale: Disulfiram, an aldehyde dehydrogenase blocker, is used in alcoholism to deter drinking. When alcohol is consumed, acetaldehyde accumulates, causing nausea . Bradycardia isn't typical; tachycardia may occur with acetaldehyde buildup. Elation and euphoria contradict the aversive intent. Urticaria (E) is possible but less common. Nausea, with flushing and vomiting, creates an unpleasant reaction, reinforcing abstinence. This aligns with disulfiram's mechanism, leveraging acetaldehyde toxicity to modify behavior, distinguishing it from other effects.
Restoration of blood flow results through the dissolution of clot by:
- A. fibrin
- B. plasmin
- C. thrombin
- D. prothrombin
Correct Answer: B
Rationale: Plasmin is an enzyme that is responsible for breaking down fibrin, a protein that forms blood clots. When an area of vessel needs to have its blood flow restored, such as after a clot has formed, plasmin is activated to dissolve the clot. By breaking down the fibrin mesh of the clot, plasmin helps restore normal blood flow in the affected vessel. Therefore, the restoration of blood flow results through the dissolution of clot by plasmin, making option B the correct answer.
The nurse is discharging a 35-year-old patient with diabetes who has been prescribed an adrenergic blocking agent. What is the priority teaching point for the nurse to discuss with this patient?
- A. Monitor blood glucose levels closely and report any instability
- B. Document signs and symptoms of hyperglycemia and hypoglycemia
- C. Reduce carbohydrate intake more than usual while taking the new drug
- D. Increase insulin dosage to compensate for the drug’s effect in increasing blood sugar
Correct Answer: A
Rationale: It is important for the patient to be instructed to monitor blood sugar levels more frequently because adrenergic blocking agents mask the normal hypo- and hyperglycemic manifestations that normally alert patients such as sweating, feeling tense, increased heart rate, and rapid breathing. There is no need to change the diet or the diabetic medications. There may be no signs and symptoms to record because they are blocked by the adrenergic blocker. The nurse should emphasize the importance of frequent blood glucose monitoring and reporting any instability to the healthcare provider.
A healthcare professional is preparing to administer IV Furosemide to a client with heart failure. Which of the following actions should the healthcare professional take?
- A. Administer the medication undiluted.
- B. Dilute the medication with normal saline.
- C. Administer the medication through a central line.
- D. Administer the medication slowly over 2 minutes.
Correct Answer: D
Rationale: Furosemide, when administered intravenously, should be given slowly over 2 minutes to reduce the risk of ototoxicity, a known adverse effect of rapid infusion. This method allows for better monitoring of the client's response and decreases the likelihood of adverse reactions associated with a faster administration rate.