Nokea
A client with a history of epilepsy is prescribed carbamazepine (Tegretol). The nurse should monitor the client for which of the following adverse effects?
- A. Agranulocytosis.
- B. Hypernatremia.
- C. Hypotension.
- D. Weight gain.
Correct Answer: A
Rationale: Carbamazepine can cause agranulocytosis, requiring monitoring of white blood cell counts.
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The nurse is providing care to the client who has received medication therapy with tissue plasminogen activator. Which item should the nurse have available for use as part of standard nursing care for this client?
- A. Flashlight
- B. Pulse oximeter
- C. Suction equipment
- D. Occult blood test strips
Correct Answer: D
Rationale: Tissue plasminogen activator is a thrombolytic medication that is used to dissolve thrombi or emboli caused by thrombus. A frequent and potentially adverse effect of therapy is bleeding. The nurse monitors for signs of bleeding in clients receiving this therapy. Equipment needed by the nurse would include occult blood test strips to monitor for occult blood in the urine, stool, or nasogastric drainage. A flashlight may be used for pupil assessment as part of the neurological exam in the client who is neurologically impaired. Pulse oximeter and suction equipment would be needed if the client had evidence of respiratory problems.
The nurse is caring for a client with a history of atrial fibrillation who is prescribed dofetilide (Tikosyn). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Bradycardia.
- C. Torsades de pointes.
- D. Weight gain.
Correct Answer: C
Rationale: Dofetilide can cause torsades de pointes, a life-threatening arrhythmia, requiring close monitoring.
Which of the following interventions is recommended protocol for all clients who are at risk for pressure sore development?
- A. Identify clients at risk upon admission to the health care facility.
- B. Place at-risk clients on an every-2-hour turning schedule.
- C. Automatically place clients in specialty beds.
- D. Provide at-risk clients with a high-protein, high-carbohydrate diet.
Correct Answer: B
Rationale: Regular repositioning every 2 hours prevents prolonged pressure on skin, reducing the risk of pressure sores in at-risk clients.
The nurse is teaching a client with a new diagnosis of type 1 diabetes mellitus about insulin administration. Which of the following instructions is most important?
- A. Rotate injection sites.
- B. Store insulin in the freezer.
- C. Administer insulin at bedtime only.
- D. Use the same syringe for multiple doses.
Correct Answer: A
Rationale: Rotating injection sites prevents lipodystrophy and ensures consistent insulin absorption.
The nurse is assessing a client with suspected pulmonary edema. Which of the following findings would support this diagnosis?
- A. Crackles in the lung bases.
- B. Bradypnea.
- C. Hypotension.
- D. Dry cough.
Correct Answer: A
Rationale: Crackles in the lung bases indicate fluid accumulation in pulmonary edema.