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A client with a history of atrial fibrillation is prescribed apixaban. The nurse should monitor for which potential side effect?
- A. Bleeding
- B. Weight gain
- C. Headache
- D. Nausea
Correct Answer: A
Rationale: The correct answer is A: Bleeding. Apixaban is an anticoagulant medication that works by decreasing the blood's ability to clot. One of the significant side effects of apixaban is an increased risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in the urine or stool, or unusual bleeding or bruising. Monitoring for these signs is crucial to prevent or manage any potential complications associated with the medication.
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A client with osteoporosis is prescribed raloxifene. The nurse should reinforce which instruction?
- A. Take this medication at the same time each day.
- B. Take this medication with a full glass of water.
- C. Take this medication on an empty stomach.
- D. Take this medication immediately after a meal.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What instructions should the PN reinforce with the client regarding the newly prescribed medications isosorbide dinitrate and hydrochlorothiazide?
- A. Instruct the client to use a soft bristle toothbrush.
- B. Instruct the client to slowly rise from a sitting or lying down position.
- C. Instruct the client to elevate their legs above the level of their heart.
- D. Instruct the client to limit the amount of fiber in their diet.
Correct Answer: B
Rationale: The correct instruction for the client is to slowly rise from a sitting or lying down position. Isosorbide dinitrate, a nitrate, and hydrochlorothiazide, a diuretic, can both cause hypotension. When used together, their additive effects can further lower blood pressure, leading to orthostatic hypotension. Instructing the client to change positions slowly helps prevent a sudden drop in blood pressure, reducing the risk of dizziness or falls.
A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?
- A. The client is experiencing vision and hearing loss.
- B. The client has an erection lasting longer than 2 hours.
- C. The client is complaining of nasal congestion.
- D. The client is complaining of feeling flushed.
Correct Answer: A
Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications.
A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. What action should the nurse take?
- A. Explain that the medication may take time to show improvement in symptoms
- B. Withhold the medication and notify the healthcare provider
- C. Advise the client to undergo liver function tests
- D. Document the assessment findings in the electronic health record
Correct Answer: D
Rationale: In this scenario, the nurse's priority is to document the assessment findings in the electronic health record. This action is crucial for maintaining an accurate record of the client's health status and can provide valuable information for the healthcare team. Withholding medication or advising additional tests should only be done after consulting with the healthcare provider based on the documented assessment findings.
A 43-year-old female client who has had a thyroidectomy due to Grave's disease is prescribed a thyroid replacement hormone. Which signs and symptoms are associated with thyroid hormone toxicity and should be reported promptly to the health care provider?
- A. Tinnitus and dizziness
- B. Tachycardia and chest pain
- C. Dry skin and intolerance to cold
- D. Weight gain and increased appetite
Correct Answer: B
Rationale: The signs and symptoms of thyroid hormone toxicity, especially when the dosage is excessive, include tachycardia (rapid heart rate) and chest pain. These symptoms are indicative of hyperthyroidism, where the body receives an excessive amount of thyroid hormone. It is crucial to report these symptoms promptly to the healthcare provider to adjust the medication dosage and prevent potential complications.