Nokea
A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?
- A. Irregular heart rhythm
- B. Abnormal uterine bleeding
- C. Yellowing of the sclera or dark-colored urine
- D. Difficulty swallowing
Correct Answer: B
Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.
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A patient is receiving an IV infusion of heparin and was started on warfarin therapy the night
- A. Which statement is most correct?
- B. The patient is receiving a double dose of anticoagulants.
- C. The heparin therapy was ineffective, so the warfarin was starte
- D. The heparin provides anticoagulation until therapeutic levels of warfarin are reache
Correct Answer: D
Rationale: The correct statement is that the heparin provides anticoagulation until therapeutic levels of warfarin are reached. Heparin has an immediate onset of action and is used initially to rapidly provide anticoagulation. Warfarin, on the other hand, has a delayed onset of action and requires several days to reach therapeutic levels in the bloodstream. Therefore, heparin is often overlapped with warfarin until the latter reaches its full anticoagulant effect. This overlapping strategy helps prevent a gap in anticoagulation and reduces the risk of blood clots. So, the statement that the heparin provides anticoagulation until therapeutic levels of warfarin are reached is the most correct in this case.
The client tells the nurse that her symptoms have become worse since she has been using oxymetazoline (Afrin) for nasal congestion. What is the best assessment question for the nurse to ask?
- A. How old is the bottle you are using?'
- B. May I take your temperature?'
- C. Are you using any other inhaled medications?'
- D. How long have you been using the medication?'
Correct Answer: D
Rationale: Oxymetazoline, a nasal decongestant, can cause rebound congestion (rhinitis medicamentosa) if used beyond 3-5 days, worsening symptoms due to vascular dependence. The best assessment question is how long the client has used it, as prolonged use is the likely culprit, guiding the nurse to educate on discontinuation or seek medical advice. The bottle's age might affect potency but isn't the primary concern for worsening symptoms. Temperature checks for infection, a secondary issue here. Other inhaled medications could interact but don't directly explain rebound effects. The nurse prioritizes duration to pinpoint misuse, a common issue with topical decongestants, making choice D critical for accurate assessment and intervention.
A nurse is providing discharge teaching to a client who has a new prescription for Warfarin. Which of the following statements should the nurse include?
- A. You should avoid taking aspirin for headaches while on this medication.
- B. You should use a soft toothbrush to brush your teeth.
- C. You should avoid foods that are rich in vitamin K.
- D. You should avoid prolonged exposure to sunlight.
Correct Answer: B
Rationale: The correct statement to include in discharge teaching for a client prescribed Warfarin is to use a soft toothbrush to prevent gum bleeding. Warfarin is an anticoagulant that increases the risk of bleeding, so using a soft toothbrush can help prevent gum injury and bleeding. Choice A is incorrect because aspirin, another blood-thinning medication, should generally be avoided while on Warfarin to reduce the risk of bleeding. Choice C is incorrect because clients on Warfarin should maintain a consistent intake of vitamin K-rich foods rather than avoid them completely. Choice D is unrelated to the medication and not a priority teaching point for a client prescribed Warfarin.
The newly licensed nurse is preparing to administer a high dose of androgen to the female client. The nurse manager asks for the rationale. What is the best response by the new nurse?
- A. My client wants to improve athletic performance
- B. My client has breast cancer
- C. My client has brain cancer
- D. My client is planning on sexual reassignment surgery
Correct Answer: B
Rationale: High-dose androgen therapy in females is occasionally used as a palliative treatment for certain breast cancers, particularly hormone-sensitive types, where it suppresses estrogen-driven tumor growth, offering symptom relief in advanced stages. Using androgens for athletic performance enhancement, while possible due to their anabolic effects, isn't a clinical indication and is illegal in regulated settings. Brain cancer lacks evidence supporting androgen use, as it doesn't target neurological malignancies. Sexual reassignment involves testosterone for masculinization, but high doses in a clinical context typically align with cancer care, not transition protocols. The breast cancer rationale reflects a recognized, albeit niche, therapeutic use, leveraging androgens' anti-estrogenic properties to slow disease progression, making it the most defensible clinical justification in this scenario.
A client has a new prescription for Pancrelipase. Which of the following instructions should the nurse include?
- A. Take the medication with meals and snacks.
- B. Expect your urine to turn orange.
- C. Increase your intake of high-calcium foods.
- D. Avoid consuming dairy products.
Correct Answer: A
Rationale: The correct answer is A: 'Take the medication with meals and snacks.' Pancrelipase should be taken with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This timing ensures that the medication functions optimally by assisting in the digestion process when food is present in the gastrointestinal system. Choice B is incorrect because urine discoloration is not a common side effect of Pancrelipase. Choice C is incorrect as there is no specific need to increase high-calcium foods with Pancrelipase. Choice D is also incorrect as avoiding dairy products is not necessary when taking Pancrelipase.