Nokea
A client with a diagnosis of breast cancer is prescribed letrozole (Femara). The nurse should instruct the client to report which of the following side effects immediately?
- A. Hot flashes.
- B. Bone pain.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Bone pain may indicate bone loss or metastasis, a serious side effect of letrozole requiring immediate reporting.
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You are a registered nurse who is performing the role of a case manager in your hospital. You have been asked to present a class to newly employed nurses about your role, your responsibilities and how they can collaborate with you as the case manager. Which of the following is a primary case management responsibility associated with reimbursement that you should include in this class?
- A. The case manager's role in terms of organization wide performance improvement activities
- B. The case manager's role in terms complete, timely and accurate documentation
- C. The case manager's role in terms of the clients' being at the appropriate level of care
- D. The case manager's role in terms of contesting denied reimbursements
Correct Answer: C
Rationale: A primary case management responsibility related to reimbursement is ensuring that clients are at the appropriate level of care , which directly impacts reimbursement by ensuring services match medical necessity and payer requirements.
The nurse is evaluating the client's potential for development of a pressure sore. Which of the following individual characteristics would be the best indicator of risk for the client's developing a pressure sore?
- A. The client's nutritional status.
- B. The client's circulatory status.
- C. The client's mobility status.
- D. The client's orientation status.
Correct Answer: C
Rationale: Immobility is the primary risk factor for pressure sores, as it leads to prolonged pressure on tissues.
A school-age child diagnosed with attention deficit hyperactivity disorder is prescribed methylphenidate (Ritalin). Which of the following should alert the school nurse to the possibility that the child is experiencing a common side effect of the drug?
- A. Loss of appetite
- B. Vomiting
- C. Photosensitivity
- D. Weight gain
Correct Answer: A
Rationale: Loss of appetite is a common side effect of methylphenidate, often leading to weight loss. Vomiting and photosensitivity are less common, and weight gain is not typical.
A client with a history of deep vein thrombosis is prescribed enoxaparin (Lovenox). Which laboratory value does not require routine monitoring?
- A. Platelet count
- B. Prothrombin time (PT)
- C. Activated partial thromboplastin time (aPTT)
- D. Hemoglobin
Correct Answer: B
Rationale: Enoxaparin, a low-molecular-weight heparin, does not require routine PT monitoring, unlike warfarin, as it primarily affects anti-factor Xa activity.
Which sound should you expect to hear when you percuss the liver during a complete physical assessment?
- A. Resonance
- B. Flatness
- C. Tympany
- D. Dullness
Correct Answer: D
Rationale: The liver, a solid organ, produces a dull sound when percussed, as opposed to the tympanic sound of air-filled structures or the resonant sound of lung tissue.