Nokea
A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?
- A. Taking four medications decreases the risk for a severe allergic reaction.
- B. Taking four medications reduces the chance that the bacteria will become resistant.
- C. Taking four medications reduces the risk for adverse reactions.
- D. Taking four medications decreases the chance of having a positive tuberculin skin test.
Correct Answer: B
Rationale: When treating tuberculosis, using a combination of multiple medications is crucial to reduce the risk of bacterial resistance. The use of four medications helps to target the bacteria from different angles, making it harder for them to develop resistance to the treatment. This approach is essential to ensure the effectiveness of the treatment regimen and to prevent the spread of drug-resistant strains of tuberculosis.
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A client has a new prescription for spironolactone. The client should be monitored for which of the following adverse effects?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia as an adverse effect. Hyperkalemia is characterized by elevated levels of potassium in the blood, which can be dangerous and lead to cardiac arrhythmias. Therefore, monitoring for signs and symptoms of hyperkalemia is crucial when a client is taking spironolactone.
A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?
- A. BUN
- B. Creatinine
- C. Hemoglobin
- D. White blood cell count
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
An adolescent male is newly diagnosed with schizophrenia. Which of the following antipsychotic agents may have the best chance to improve his apathy and blunted affect?
- A. Chlorpromazine
- B. Fluphenazine
- C. Haloperidol
- D. Risperidone
Correct Answer: D
Rationale: Risperidone, a second-generation antipsychotic, blocks D2 and 5HT2 receptors, improving positive symptoms (hallucinations) and, to some extent, negative symptoms like apathy and blunted affect, common in schizophrenia's prodrome. First-generation agents—chlorpromazine, fluphenazine, haloperidol—target D2 receptors, effectively reducing positive symptoms but often worsening negative symptoms via dopamine blockade in the prefrontal cortex. Thioridazine, also first-generation, has similar limitations. Risperidone's serotonin antagonism may enhance prefrontal dopamine release, offering a modest edge in addressing negative symptoms, supported by studies, making it preferable for this adolescent's presentation.
A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?
- A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
- B. Leucovorin increases platelet production and prevents bleeding.
- C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
- D. Leucovorin protects healthy cells from Methotrexate's toxic effects.
Correct Answer: D
Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment.
A client with congestive heart failure taking digoxin refused breakfast and is complaining of nausea and weakness. Which action should the nurse take first?
- A. Check the client's vital signs.
- B. Request a dietitian consult.
- C. Suggest that the client rests before eating the meal.
- D. Request an order for an antiemetic.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.