Nokea
A client is scheduled to receive methotrexate (Folex), 0.625 mg/kg P.O. daily, to treat malignant lymphoma. Before administering the drug, the nurse reviews the client's medication history. Which of the following drugs might interact with methotrexate?
- A. digoxin (Lanoxin)
- B. Probenecid (Benemid)
- C. theophylline (Slo-Phyllin)
- D. Famotidine (Pepcid)
Correct Answer: B
Rationale: Probenecid is a drug that can interact with methotrexate by inhibiting its renal tubular secretion, leading to increased methotrexate levels and potential toxicity. It is essential to monitor the client closely for signs of methotrexate toxicity if both drugs are being used concurrently. The other options, digoxin, theophylline, and famotidine, do not have significant interactions with methotrexate that would result in increased toxicity.
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A few minutes after beginning a blood transfusion, the nurse notes that the client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing which problem?
- A. A hemolytic reaction to mismatched blood
- B. A hemolytic reaction to Rh-incompatible blood
- C. A hemolytic allergic reaction caused by bacterial contamination of donor blood
- D. None of the above
Correct Answer: A
Rationale: The client is likely experiencing a hemolytic reaction to mismatched blood due to the symptoms of chills, dyspnea, and urticaria occurring shortly after beginning the blood transfusion. These symptoms are classic signs of a transfusion reaction, especially a hemolytic reaction where the recipient's immune system attacks the transfused red blood cells. This can happen if the donor blood is not compatible with the recipient's blood type, leading to a severe reaction. It is crucial to report this immediately to the physician to halt the transfusion and provide appropriate treatment to the client.
Austin, age 6 months, has six teeth. How should the nurse interpret this finding?
- A. Normal tooth eruption
- B. Delayed tooth eruption
- C. Unusual and dangerous
- D. Earlier-than-normal tooth eruption
Correct Answer: A
Rationale: The eruption of teeth in infants typically begins around 6 months of age, with the lower central incisors being the first to appear. Having six teeth at 6 months old is within the normal range of tooth eruption for infants. The average time frame for infants to have their first teeth is between 4 to 7 months, so Austin's situation falls within that range. There is no cause for concern or interpretation of the finding as unusual or dangerous in this scenario.
The nurse is preparing to perform a physical assessment on a 10-year-old girl. The nurse gives her the option of her mother either staying in the room or leaving. How should this action be interpreted?
- A. Appropriate because of child's age
- B. Appropriate because mother would be uncomfortable making decisions for child
- C. Inappropriate because of child's age
- D. Inappropriate because child is same sex as mother
Correct Answer: A
Rationale: It is appropriate for the nurse to offer the 10-year-old girl the option of having her mother stay in the room during the physical assessment because of the child's age. At this age, children may start to seek more independence and privacy, and allowing the child to make the decision can help promote a sense of autonomy and respect for her feelings. It is important to consider the child's preferences and comfort during medical procedures, which can help build trust and improve the overall experience for the child.
A patient with a brain tumor is admitted to the medical unit to begin radiation treatments. Which nursing action should take priority?
- A. Pad the patient's side rails
- B. Teach the patient what to expect during
- C. Assess the patient's pain level radiation treatments
- D. Place the patient in isolation
Correct Answer: C
Rationale: Assessing the patient's pain level should take priority in this situation because pain management is crucial for the comfort and well-being of the patient with a brain tumor undergoing radiation treatments. Pain can affect the patient's overall quality of life and participation in treatment. By promptly assessing the patient's pain level, the nurse can determine the need for appropriate pain management interventions to ensure the patient's comfort and enhance treatment outcomes. It is important to address the patient's pain to provide holistic care and improve the patient's overall experience during the treatment process.
The nurse is caring for a patient with HIV. Which of the following foods would the nurse teach the patient is safe to eat to reduce the risk of infection?
- A. Raw fruits
- B. Raw vegetables
- C. Cooked vegetables
- D. Caesar dressing
Correct Answer: C
Rationale: For a patient with HIV, it is important to reduce the risk of infection by avoiding potentially contaminated foods. Cooked vegetables are safer to eat compared to raw fruits and vegetables since cooking helps to kill harmful pathogens that can be present on raw produce. Caesar dressing, which typically contains raw eggs, should also be avoided as these can pose a risk of foodborne illness for individuals with compromised immune systems like those with HIV. Therefore, the nurse should teach the patient that cooked vegetables are a safer option for reducing the risk of infection.