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A client with a diagnosis of rheumatoid arthritis is prescribed methotrexate (Rheumatrex). The nurse should teach the client to avoid which of the following while taking this medication?
- A. Exposure to sunlight.
- B. Alcohol consumption.
- C. High-fiber foods.
- D. Regular exercise.
Correct Answer: B
Rationale: Alcohol consumption should be avoided with methotrexate due to the increased risk of hepatotoxicity.
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A 12-year-old boy is admitted due to depression and post-trauma response. Child Protective Services reports that the boy's father is now in jail for molesting him from ages 6 to 9. Given the typical reactions of incest victims, the nurse should assess the child for which behavior? Select all that apply.
- A. Sexualized play.
- B. Aggression.
- C. Isolation at home.
- D. Running away.
- E. Truancy.
Correct Answer: A, B, C, D, E
Rationale: Incest victims may exhibit sexualized play, aggression, isolation, running away, and truancy as coping mechanisms or trauma responses.
The nurse finds a client lying on the floor next to the bed. After returning the client to bed, assessing for injury, and notifying the physician, the nurse fills out an incident report. Which of the following is the nurse's next action?
- A. Give the incident report to the nurse-manager.
- B. Place the incident report on the chart.
- C. Call the family to inform them.
- D. Omit mentioning the fall in the chart documentation.
Correct Answer: A
Rationale: The incident report should be given to the nurse-manager for review and follow-up, as it is an internal document for quality improvement, not part of the medical record.
The nurse is caring for a client with a history of heart failure who is receiving carvedilol (Coreg). The nurse should monitor the client for which of the following adverse effects?
- A. Bradycardia.
- B. Hyperglycemia.
- C. Hypertension.
- D. Weight loss.
Correct Answer: A
Rationale: Carvedilol, a beta-blocker, can cause bradycardia, requiring heart rate monitoring.
An 80-year-old client with severe kidney damage is placed on life support and dialysis. Care decisions are being made by his wife, who is showing signs of early Alzheimer's disease. The client's daughter arrives from out of town with a copy of the client's living will, which states that the client did not want to be on life support. The nurse should:
- A. Immediately inform the physician about the living will.
- B. Suggest to the daughter that she discuss her father's wishes with her mother.
- C. Prepare to remove the client from life support.
- D. Make a copy of the living will and give it to the client's wife.
Correct Answer: A
Rationale: Informing the physician about the living will ensures that the client's wishes are addressed promptly.
An older client has been prescribed casanthranol on a long-term basis to treat constipation. The nurse determines that which laboratory finding is a result of the side/adverse effects of this medication?
- A. Sodium 135 mEq/L (135 mmol/L)
- B. Sodium 145 mEq/L (145 mmol/L)
- C. Potassium 3.1 mEq/L (3.1 mmol/L)
- D. Potassium 5.0 mEq/L (5.0 mmol/L)
Correct Answer: C
Rationale: Hypokalemia can result from long-term use of casanthranol, which is a laxative. The medication stimulates peristalsis and alters fluid and electrolyte transport, thus helping fluid to accumulate in the colon. The normal range for potassium is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L). The normal range for sodium is 135 to 145 mEq/L (135 to 145 mmol/L). The remaining options all suggest normal values.