Nokea
A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?
- A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
- B. Leucovorin increases platelet production and prevents bleeding.
- C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
- D. Leucovorin protects healthy cells from Methotrexate's toxic effects.
Correct Answer: D
Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment.
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When teaching a client with a new prescription for nitroglycerin patches, which of the following instructions should the nurse include?
- A. Apply the patch at the same time every day.
- B. Rotate the application site daily.
- C. Remove the patch for 12 hours each day.
- D. Cut the patch in half if needed.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client has a new prescription for Filgrastim. Which of the following instructions should be included by the healthcare provider?
- A. Take this medication with food.
- B. Avoid taking this medication with orange juice.
- C. Report bone pain to your healthcare provider.
- D. Expect a persistent cough while taking this medication.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Individuals who are slow acetylators (i.e. have a relatively low activity of hepatic N-acetyltransferase):
- A. Have a prevalence of 15-20 per cent in European caucasians
- B. Are more likely to develop thrombocytopenia, nephrotic syndrome and rash during gold treatment
- C. Are more likely to develop hepatotoxicity following halothane anaesthesia
- D. Are more likely to develop antinuclear antibodies during hydralazine therapy
Correct Answer: D
Rationale: Slow acetylators have reduced hepatic N-acetyltransferase (NAT2) activity, affecting metabolism of drugs like hydralazine, isoniazid, and procainamide. In European Caucasians, prevalence is actually 50-60%, not 15-20%, making that statement inaccurate. Gold treatment side effects like thrombocytopenia or nephrotic syndrome aren't strongly linked to acetylation status, but rather to immune responses, so that's less relevant. Halothane hepatotoxicity relates to immune-mediated reactions or metabolites, not acetylation speed. Hydralazine, metabolized by NAT2, accumulates in slow acetylators, increasing risk of drug-induced lupus with antinuclear antibodies (ANA), a well-documented association. Agranulocytosis with clozapine isn't tied to acetylation but to idiosyncratic reactions. The ANA risk with hydralazine is the most accurate, reflecting its pharmacogenetic implications, critical for personalized dosing and monitoring.
A client has a prescription for hydrochlorothiazide to treat hypertension. The nurse should monitor the client for which of the following adverse effects?
- A. Hypokalemia
- B. Hypertension
- C. Hyperglycemia
- D. Hypercalcemia
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
At what amount does Acetaminophen stop effectively controlling pain?
- A. Over 1,000 mg
- B. 750 mg
- C. Over 1,500 mg
- D. 150 mg
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.