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A client with a history of deep vein thrombosis is prescribed warfarin. The nurse should monitor for which potential adverse effect?
- A. Increased risk of bleeding
- B. Decreased risk of bleeding
- C. Increased risk of infection
- D. Decreased risk of infection
Correct Answer: A
Rationale: The correct answer is A: Increased risk of bleeding. Warfarin is an anticoagulant medication that works by prolonging the time it takes for blood to clot. Therefore, a potential adverse effect of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, nosebleeds, or blood in the urine or stool. Monitoring for these signs is essential to prevent serious complications associated with excessive bleeding.
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A client with diabetes mellitus type 2 is prescribed liraglutide. The nurse should include which instruction in the client's teaching plan?
- A. Administer this medication once a week.
- B. Administer this medication once a month.
- C. Administer this medication twice a day.
- D. Administer this medication once a day.
Correct Answer: D
Rationale: The correct answer is to administer liraglutide once a day. Liraglutide is typically prescribed to be taken once daily, as directed by the healthcare provider. This dosing schedule helps maintain consistent levels of the medication in the body to effectively manage blood sugar levels in clients with diabetes mellitus type 2. It is important for the nurse to emphasize the importance of adherence to the prescribed dosing regimen to achieve optimal therapeutic outcomes.
A client with a history of atrial fibrillation is prescribed sotalol. The nurse should monitor for which potential side effect?
- A. Bradycardia
- B. Tachycardia
- C. Headache
- D. Hyperglycemia
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?
- A. Serum hepatic enzymes
- B. Fingerstick glucose
- C. Stool color and character
- D. Serum electrolytes and ammonia
Correct Answer: D
Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition.
What instruction should the nurse include in the teaching plan for a client prescribed etanercept for rheumatoid arthritis?
- A. Rotate injection sites to prevent irritation.
- B. Take this medication with food to reduce gastrointestinal upset.
- C. Avoid sunlight exposure while on this medication.
- D. Notify the healthcare provider of any signs of infection.
Correct Answer: A
Rationale: The correct instruction for a client prescribed etanercept is to rotate injection sites to prevent irritation and ensure proper absorption. Changing sites will help prevent skin irritation and ensure that the medication is absorbed effectively. This practice also reduces the risk of injection site reactions and discomfort. It is essential to follow this instruction to promote optimal medication delivery and minimize adverse effects.
A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?
- A. Apical heart rate of 60 beats/min
- B. Sweating across the forehead
- C. Poor sucking effort
- D. Respiratory rate of 30 breaths/min
Correct Answer: A
Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects.