Nokea
A client is starting therapy with filgrastim. Which of the following adverse effects should the nurse instruct the client to monitor?
- A. Bone pain
- B. Constipation
- C. Tinnitus
- D. Dry mouth
Correct Answer: A
Rationale: When a client is starting therapy with filgrastim, monitoring for bone pain is essential. Filgrastim can lead to increased bone marrow activity, resulting in bone pain as a common adverse effect. Instructing the client to monitor and report any bone pain promptly can help in managing this side effect effectively.
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When starting therapy with cisplatin, a client should report which of the following adverse effects as instructed by the nurse?
- A. Tinnitus
- B. Nausea
- C. Constipation
- D. Weight gain
Correct Answer: A
Rationale: The nurse should instruct the client to report tinnitus because it can be an indication of ototoxicity, a potential adverse effect of cisplatin. Ototoxicity can manifest as tinnitus, hearing loss, or balance disturbances, so it is crucial for the client to promptly report any changes in hearing such as tinnitus to prevent further damage.
A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?
- A. Remove the prior dose before applying a new dose.
- B. Rub the ointment directly into the skin until it is no longer visible.
- C. Cover the applied ointment with a clean gauze pad.
- D. Apply the ointment to the same skin area each time.
Correct Answer: A
Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.
A client has a new prescription for Allopurinol. Which of the following instructions should be included by the healthcare provider?
- A. Take this medication at bedtime.
- B. Increase your fluid intake.
- C. Avoid foods high in calcium.
- D. Take this medication with meals.
Correct Answer: B
Rationale: Allopurinol can increase the risk of kidney stones as a side effect. To prevent this adverse effect, it is essential for the client to increase their fluid intake. Adequate hydration can help in preventing the formation of kidney stones by keeping urine dilute and flushing out substances that can lead to stone formation.
During an admission assessment for a client with severe Aspirin toxicity, what finding should the nurse expect?
- A. Body temperature 35°C (95°F)
- B. Lung crackles
- C. Cool, dry skin
- D. Respiratory depression
Correct Answer: D
Rationale: In severe Aspirin toxicity, respiratory depression can occur due to increasing respiratory acidosis. Aspirin toxicity leads to metabolic acidosis, stimulating the respiratory center in the brain to increase the respiratory rate initially. However, as the toxicity worsens, respiratory muscle fatigue and depression can occur, resulting in respiratory depression. This can lead to hypoxia, respiratory failure, and ultimately, respiratory arrest.
A client receives a local anesthetic of Lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client?
- A. Seizures
- B. Tachycardia
- C. Hypertension
- D. Fever
Correct Answer: A
Rationale: Seizures are a potential adverse reaction to local anesthetics like Lidocaine. Lidocaine can affect the central nervous system and, in some cases, lead to seizure activity. Therefore, it is important for the nurse to monitor the client for any signs of seizures during and after the administration of Lidocaine.