A client is receiving treatment with methotrexate. Which of the following supplements should the nurse instruct the client to take?
- A. Folic acid
- B. Vitamin D
- C. Calcium
- D. Iron
Correct Answer: A
Rationale: The nurse should instruct the client to take folic acid when receiving treatment with methotrexate to reduce the risk of methotrexate toxicity. Methotrexate acts as a folic acid antagonist, leading to folic acid deficiency, which can be counteracted by supplementing with folic acid. Vitamin D, calcium, and iron are not specifically recommended to counteract methotrexate effects and do not play a significant role in mitigating methotrexate toxicity.
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A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?
- A. Dry oral mucous membranes
- B. Nausea and vomiting
- C. Temperature of 38.1°C (100.6°F)
- D. Anorexia
Correct Answer: C
Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.
A healthcare provider is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare provider should monitor the client for which of the following as an adverse effect of this medication?
- A. Bradycardia
- B. Hyperkalemia
- C. Hypoglycemia
- D. Hypocalcemia
Correct Answer: B
Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, leading to potassium retention. Monitoring potassium levels is essential to prevent complications associated with hyperkalemia. Bradycardia (Choice A) is not a common adverse effect of Enalapril. Enalapril does not typically affect glucose levels, so hypoglycemia (Choice C) is not a common concern with this medication. Enalapril does not directly impact calcium levels, so hypocalcemia (Choice D) is not a typical adverse effect.
A client asks a nurse about Feverfew. Which response should the nurse provide?
- A. It is used to treat skin infections.
- B. It can decrease the frequency of migraine headaches.
- C. It can lessen the nasal congestion in the common cold.
- D. It can relieve nausea of morning sickness during pregnancy.
Correct Answer: B
Rationale: The correct response is B: 'It can decrease the frequency of migraine headaches.' Feverfew is known for reducing the frequency of migraine headaches, but it has not been proven to relieve an existing migraine headache. Choices A, C, and D are incorrect because Feverfew is not used to treat skin infections, lessen nasal congestion in the common cold, or relieve nausea of morning sickness during pregnancy.
A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
- A. Take one tablet at the first sign of chest pain.
- B. If pain is not relieved, take another tablet in 10 minutes.
- C. You can take up to five tablets in 15 minutes.
- D. Swallow the tablet with water.
Correct Answer: A
Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.
A client is receiving treatment with vincristine. Which of the following findings should the nurse monitor?
- A. Hyperkalemia
- B. Neurotoxicity
- C. Neutropenia
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Neurotoxicity. Vincristine is known to cause neurotoxicity as an adverse effect due to its impact on the nervous system. Monitoring for neurotoxicity is crucial to detect any signs early. Choices A, C, and D are incorrect. Hyperkalemia is not a typical finding associated with vincristine. Neutropenia is a common side effect of chemotherapy but is not directly related to vincristine. Bradycardia is not a common adverse effect of vincristine.