Nokea
A client with a history of breast cancer is prescribed letrozole (Femara). The nurse should monitor the client for which of the following adverse effects?
- A. Bone loss.
- B. Hyperglycemia.
- C. Hypertension.
- D. Weight gain.
Correct Answer: A
Rationale: Letrozole, an aromatase inhibitor, can cause bone loss, increasing osteoporosis risk.
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The nurse makes a home visit to a primiparous client and her neonate at 1 week after a vaginal delivery. Which of the following findings should be reported to the physician?
- A. A scant amount of maternal lochia serosa.
- B. The presence of a neonatal tonic neck reflex.
- C. A nonpalpable maternal fundus.
- D. Neonatal central cyanosis.
Correct Answer: D
Rationale: Neonatal central cyanosis indicates possible respiratory or cardiac issues and requires immediate reporting. The other findings are normal at 1 week postpartum.
A client with a new diagnosis of hypothyroidism is prescribed levothyroxine. What should the nurse include in the teaching plan?
- A. Take the medication at bedtime.
- B. Expect weight gain as a side effect.
- C. Report palpitations or chest pain.
- D. Stop the medication if nausea occurs.
Correct Answer: C
Rationale: Palpitations or chest pain may indicate overmedication or cardiac effects, requiring prompt reporting to adjust the levothyroxine dose.
Sulfadiazine has been ordered for a client who has a urinary tract infection. Which of the following recommend is most appropriate for administering sulfonamides?
- A. Encourage the client to take the medication with meals.
- B. Instruct the client to drink at least 8 glasses of water a day.
- C. Measure the client's urine output.
- D. Instruct the client that the urine may turn reddish orange.
Correct Answer: B
Rationale: Adequate hydration (8 glasses of water daily) prevents crystalluria, a complication of sulfonamides.
A client with a history of chronic lymphocytic leukemia is admitted with fatigue and pallor. Which laboratory value should the nurse monitor?
- A. Hemoglobin
- B. White blood cell count
- C. Platelet count
- D. All of the above
Correct Answer: D
Rationale: Chronic lymphocytic leukemia can cause anemia (low hemoglobin), infection risk (abnormal WBCs), and bleeding risk (low platelets), requiring monitoring of all values.
The physician orders I.V. cefazolin (Kefzol) 1g for a client. In preparing to administer the Kefzol, the nurse notes that the client is allergic to penicillin. Based on this information, what is an appropriate action for the nurse to take?
- A. Continue to prepare to administer the Kefzol as ordered
- B. Notify the physician of the client's allergy to penicillin
- C. Administer the Kefzol, staying at the client's bedside during the infusion
- D. Call the pharmacist to verify that the Kefzol should be administered as ordered
Correct Answer: B
Rationale: Cefazolin, a cephalosporin, has a risk of cross-reactivity in penicillin-allergic clients, so the nurse should notify the physician to consider an alternative. Administering or verifying with the pharmacist without physician consultation is unsafe.