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A client with a history of rheumatoid arthritis is prescribed methotrexate. The nurse should monitor the client for which of the following adverse effects?
- A. Hepatotoxicity.
- B. Hyperkalemia.
- C. Hypotension.
- D. Weight gain.
Correct Answer: A
Rationale: Methotrexate can cause hepatotoxicity, requiring regular liver function tests.
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The nurse teaches a pregnant client to perform Kegel exercises. Which statement by the client indicates an understanding of the purpose of these types of exercises?
- A. The exercises will help reduce backache.
- B. The exercises will help prevent ankle edema.
- C. The exercises will help strengthen the pelvic floor.
- D. The exercises will help prevent urinary tract infections.
Correct Answer: C
Rationale: Kegel exercises assist in strengthening the pelvic floor (pubococcygeal muscle). Pelvic tilt exercises help reduce backaches. Leg elevation assists in preventing ankle edema. Instructing a client to drink 8 ounces of fluids 6 times a day helps prevent urinary tract infections.
The nurse is teaching a client with a new diagnosis of hypertension about medication adherence. Which of the following statements by the client indicates a need for further teaching?
- A. I'll take my medication every morning.'
- B. I'll check my blood pressure regularly.'
- C. I'll stop my medication if I feel fine.'
- D. I'll avoid high-sodium foods.'
Correct Answer: C
Rationale: Stopping medication when feeling fine indicates a misunderstanding, as hypertension requires ongoing treatment.
A client is admitted with acute pancreatitis. The nurse should monitor which of the following laboratory values?
- A. Decreased urine amylase level.
- B. Increased calcium level.
- C. Decreased glucose level.
- D. Increased serum amylase and lipase levels.
Correct Answer: D
Rationale: Acute pancreatitis causes elevated serum amylase and lipase due to pancreatic enzyme release, key diagnostic markers.
The nurse is caring for a client with a venous leg ulcer. Which of the following interventions should be included in the plan of care?
- A. Apply compression bandages.
- B. Keep the leg in a dependent position.
- C. Clean the ulcer with alcohol-based solution.
- D. Restrict fluid intake.
Correct Answer: A
Rationale: Compression bandages promote venous return and healing in venous leg ulcers.
An intravenous dose of lorazepam is prescribed for a client. Which data from the client's history would indicate the need to consult with the primary health care provider before administering the medication?
- A. Glaucoma
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Coronary artery disease
Correct Answer: A
Rationale: Lorazepam is a benzodiazepine and is contraindicated in clients who are comatose, with preexisting central nervous system (CNS) depression, with uncontrolled severe pain, and those with narrow-angle glaucoma. It is also contraindicated if hypersensitivity or cross-sensitivity with other benzodiazepines exists. It is also not prescribed for clients who are pregnant or breast-feeding.