Nokea
A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?
- A. The client had a prior myocardial infarction.
- B. The client takes warfarin for atrial fibrillation.
- C. The client takes an SSRI for depression.
- D. An ECG indicates a first-degree heart block.
Correct Answer: D
Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.
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A patient is being discharged with a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take the medication before bedtime.
- B. Monitor for increased blood pressure.
- C. Take the medication with food.
- D. Monitor for leg cramps.
Correct Answer: D
Rationale: The correct instruction the nurse should include is to monitor for leg cramps. Leg cramps can be a sign of hypokalemia, which is a potential adverse effect of Hydrochlorothiazide. By monitoring for leg cramps, the patient can detect signs of low potassium levels and report them to the healthcare provider promptly. This proactive approach helps prevent complications associated with hypokalemia. The other options are incorrect because taking Hydrochlorothiazide before bedtime or with food is not specific to the medication's adverse effects. Monitoring for increased blood pressure is not typically a common adverse effect of this medication.
A healthcare professional is educating a client who is beginning therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?
- A. Dyspnea
- B. Constipation
- C. Tinnitus
- D. Dry mouth
Correct Answer: A
Rationale: The correct answer is dyspnea. Dyspnea can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Prompt reporting of dyspnea allows for timely evaluation and management to prevent potential complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings that the client should report.
A client has a new prescription for Hydrochlorothiazide. Which of the following adverse effects should the nurse monitor?
- A. Hyponatremia
- B. Hyperkalemia
- C. Hypercalcemia
- D. Hypoglycemia
Correct Answer: A
Rationale: Corrected Rationale: Hydrochlorothiazide, a diuretic, can lead to electrolyte imbalances, particularly hyponatremia (low sodium levels). The nurse should closely monitor the client's sodium levels due to the potential adverse effect of Hydrochlorothiazide.
Incorrect Rationales:
- Hyperkalemia (Choice B) is less likely to be caused by Hydrochlorothiazide; in fact, it can lead to hypokalemia.
- Hypercalcemia (Choice C) is not a common adverse effect of Hydrochlorothiazide.
- Hypoglycemia (Choice D) is not directly associated with Hydrochlorothiazide use.
A client who is receiving combination chemotherapy is exhibiting a temperature of 38.1°C (100.6°F). Which of the following findings should the nurse identify as an indication of an oncologic emergency?
- A. Dry oral mucous membranes
- B. Nausea and vomiting
- C. Temperature of 38.1°C (100.6°F)
- D. Anorexia
Correct Answer: C
Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients undergoing chemotherapy due to the heightened risk of sepsis in immunocompromised individuals. Immediate assessment and intervention are crucial to prevent severe complications. Dry oral mucous membranes, nausea and vomiting, and anorexia are common side effects of chemotherapy but are not specific indicators of an oncologic emergency like a fever in this setting.
A client who is withdrawing from alcohol has been prescribed Propranolol. Which information should the nurse include in the teaching?
- A. Increases the risk for seizure activity.
- B. Provides a form of aversion therapy.
- C. Decreases cravings.
- D. Results in mild hypertension.
Correct Answer: C
Rationale: The correct information the nurse should include in the teaching is that Propranolol decreases cravings for alcohol. Propranolol is used as an adjunct medication during alcohol withdrawal to help reduce the desire for alcohol. Choice A is incorrect as Propranolol does not increase the risk for seizure activity; it can actually be used to prevent alcohol withdrawal seizures. Choice B is also incorrect as Propranolol does not provide aversion therapy. Choice D is incorrect as Propranolol is not known to result in mild hypertension.