Nokea
A client with a diagnosis of polycythemia vera is prescribed hydroxyurea (Hydrea). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Bone marrow suppression.
- C. Hyperkalemia.
- D. Weight gain.
Correct Answer: B
Rationale: Hydroxyurea can cause bone marrow suppression, requiring monitoring of blood counts for anemia or leukopenia.
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A client who has been taking diazepam (Valium) for 3 months for skeletal muscle spasms and the patient was a secret agent to the medication and the medication days ago because it was no longer helping him, but now he feels terrible. The nurse should assess the client for which of the following? Select all that apply.
- A. Insomnia.
- B. Euphoria.
- C. Bradycardia.
- D. Diaphoresis.
- E. Tremor.
- F. Vomiting.
Correct Answer: A, D, E, F
Rationale: Abrupt cessation of diazepam can cause withdrawal symptoms like insomnia, diaphoresis, tremor, and vomiting.
You are planning discharge education for your client who has a new colostomy. Which complication of a colostomy should you educate this client about?
- A. A prolapsed stoma
- B. A vitamin B12 deficiency
- C. Nocturnal enuresis
- D. GI stone formation
Correct Answer: A
Rationale: A prolapsed stoma is a known complication of a colostomy, where the stoma protrudes excessively, and clients should be educated to recognize and report it.
A client with a history of myocardial infarction is prescribed aspirin. What is the primary purpose of this medication?
- A. Reduce fever.
- B. Prevent platelet aggregation.
- C. Relieve chest pain.
- D. Lower cholesterol.
Correct Answer: B
Rationale: Aspirin prevents platelet aggregation, reducing the risk of thrombus formation in clients with a history of myocardial infarction.
The nurse is caring for a client with a history of atrial fibrillation who is prescribed amiodarone (Cordarone). Which of the following side effects should the nurse monitor for?
- A. Pulmonary toxicity.
- B. Hyperglycemia.
- C. Weight gain.
- D. Hair loss.
Correct Answer: A
Rationale: Amiodarone can cause pulmonary toxicity, a serious side effect requiring regular monitoring of lung function.
The nurse working in a long-term care setting attended a workshop on creating a restraint-free environment for the residents. When several coworkers firmly resist changing stating that their current methods are satisfactory, which action should aid the nurse in being effective in facilitating change?
- A. Pointing out to coworkers the various mistakes that they are presently making in adhering to outdated restraint procedures
- B. Informing the nursing supervisor that current restraint policies must be changed and requesting that all staff be required to comply
- C. Writing a new restraint policy over the weekend and distributing it to coworkers for immediate implementation on Monday morning
- D. Asking coworkers to help gather data comparing the facility's restraint procedures and outcomes with those of others using revised procedures
Correct Answer: D
Rationale: To be an effective change agent, the nurse must work collaboratively with others to solve common problems. The nurse who works collaboratively with others to facilitate change has a much greater chance of success than one who unilaterally demands or implements change. By enlisting the assistance of others, there is a greater chance that they will support proposed changes in procedures. To focus on errors (perceived or real) serves only to alienate others and is not effective in promoting change. A punitive atmosphere is not effective in promoting change because it discourages people from taking risks.