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A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. What action should the nurse take?
- A. Explain that the medication may take time to show improvement in symptoms
- B. Withhold the medication and notify the healthcare provider
- C. Advise the client to undergo liver function tests
- D. Document the assessment findings in the electronic health record
Correct Answer: D
Rationale: In this scenario, the nurse's priority is to document the assessment findings in the electronic health record. This action is crucial for maintaining an accurate record of the client's health status and can provide valuable information for the healthcare team. Withholding medication or advising additional tests should only be done after consulting with the healthcare provider based on the documented assessment findings.
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A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?
- A. The client is experiencing vision and hearing loss.
- B. The client has an erection lasting longer than 2 hours.
- C. The client is complaining of nasal congestion.
- D. The client is complaining of feeling flushed.
Correct Answer: A
Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications.
A client has sublingual nitroglycerine tablets prescribed to treat angina. The nurse realizes the client requires further education if the client makes which statements? (Select one that doesn't apply.)
- A. I will need to replace the nitroglycerine tablets every 3 to 5 months, not in a year.
- B. I should continue taking nitroglycerine tablets if I develop a headache.
- C. I understand nitroglycerine tablets do not cause addiction.
- D. If I feel dizzy when I take these, I should sit down or lie down until I feel better.
Correct Answer: D
Rationale: The correct answer is D. Nitroglycerine sublingual tablets need to be replaced every 3 to 5 months, not every year, making statement A incorrect. While nitroglycerine can cause a headache, it is important to continue taking the prescribed nitroglycerine if the client has angina, making statement B accurate. Nitroglycerine tablets do not cause addiction, so statement C is correct. Dizziness and weakness are associated with the hypotensive effect of nitroglycerine; therefore, if the client feels dizzy when taking them, they should sit down or lie down until they feel better. Taking nitroglycerine tablets before an activity known to cause angina can help prevent angina attacks.
A 43-year-old female client who has had a thyroidectomy due to Grave's disease is prescribed a thyroid replacement hormone. Which signs and symptoms are associated with thyroid hormone toxicity and should be reported promptly to the health care provider?
- A. Tinnitus and dizziness
- B. Tachycardia and chest pain
- C. Dry skin and intolerance to cold
- D. Weight gain and increased appetite
Correct Answer: B
Rationale: The signs and symptoms of thyroid hormone toxicity, especially when the dosage is excessive, include tachycardia (rapid heart rate) and chest pain. These symptoms are indicative of hyperthyroidism, where the body receives an excessive amount of thyroid hormone. It is crucial to report these symptoms promptly to the healthcare provider to adjust the medication dosage and prevent potential complications.
A client with a history of stroke is prescribed clopidogrel. The nurse should monitor the client for which potential side effect?
- A. Bleeding
- B. Bruising
- C. Nausea
- D. Headache
Correct Answer: A
Rationale: Clopidogrel is an antiplatelet medication that works to prevent blood clots, but it can also increase the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, or unusual bleeding from the gums. Prompt identification and management of bleeding are crucial to prevent complications.
What instructions should the practical nurse (PN) review with a client diagnosed with vaginal trichomoniasis who is prescribed oral metronidazole?
- A. Avoid direct sunlight exposure and use sunscreen product with SPF100.
- B. The client's sexual partner(s) should also be treated.
- C. Vinegar or commercial product douches should be avoided.
- D. Dairy products should be eliminated from the diet during treatment.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.