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A client with chronic obstructive pulmonary disease (COPD) is receiving prednisone (Deltasone). Which side effect should the nurse monitor for?
- A. Hypoglycemia
- B. Infection
- C. Hypotension
- D. Weight loss
Correct Answer: B
Rationale: The correct answer is B: Infection. Prednisone is a corticosteroid that suppresses the immune system, increasing the risk of infections in patients. The nurse should monitor for signs of infection such as fever, increased white blood cell count, and localized symptoms.
Rationale:
A: Hypoglycemia is not a common side effect of prednisone. Prednisone typically causes hyperglycemia.
C: Hypotension is not a common side effect of prednisone. Prednisone can actually cause fluid retention and increased blood pressure.
D: Weight loss is not a common side effect of prednisone. Prednisone can actually cause weight gain due to fluid retention and increased appetite.
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What is an important teaching point for a patient prescribed dabigatran for atrial fibrillation?
- A. Take the medication with food to enhance absorption.
- B. Do not crush or chew the capsules.
- C. Increase intake of green leafy vegetables.
- D. Avoid all dairy products.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Dabigatran is an anticoagulant medication that comes in capsules, which should not be crushed or chewed to maintain its extended-release formulation.
2. Crushing or chewing the capsules can lead to an increased risk of bleeding due to rapid release of the medication.
3. Therefore, advising the patient not to crush or chew the capsules is crucial to ensure the safety and efficacy of dabigatran therapy.
Summary:
A: Taking with food is not necessary for dabigatran absorption.
C: Green leafy vegetables are high in vitamin K, which can interfere with anticoagulant therapy.
D: There is no need to avoid all dairy products while taking dabigatran.
After performing a paracentesis on a client with ascites, 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to monitor following the procedure?
- A. Pedal pulses.
- B. Breath sounds.
- C. Gag reflex.
- D. Vital signs.
Correct Answer: D
Rationale: The correct answer is D: Vital signs. After paracentesis, monitoring vital signs is crucial as fluid removal can lead to changes in blood pressure, heart rate, and overall fluid balance. Hypotension or tachycardia may indicate hypovolemia or shock. Pedal pulses (A) are important but not as critical post-paracentesis. Breath sounds (B) are important for respiratory assessment but not directly related to fluid removal. Gag reflex (C) is unrelated to paracentesis and not a priority post-procedure.
What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?
- A. No need for regular INR monitoring
- B. Lower risk of bleeding
- C. Fewer dietary restrictions
- D. Longer half-life
Correct Answer: A
Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of DVT is the absence of regular INR monitoring required with rivaroxaban. This is because rivaroxaban is a direct oral anticoagulant with more predictable pharmacokinetics, eliminating the need for monitoring. Regular INR monitoring is necessary with warfarin to ensure the drug is within the therapeutic range, which can be burdensome for patients and healthcare providers. The other choices are incorrect as they do not directly address the primary advantage of rivaroxaban over warfarin for this specific patient population.
A patient with severe pain is prescribed morphine sulfate. What is the most important side effect for the nurse to monitor?
- A. Diarrhea
- B. Hypertension
- C. Respiratory depression
- D. Increased urine output
Correct Answer: C
Rationale: The correct answer is C: Respiratory depression. Morphine sulfate is an opioid analgesic that can suppress the respiratory drive, leading to respiratory depression, which can be life-threatening. Monitoring respiratory status is crucial to prevent complications.
Incorrect choices:
A: Diarrhea - While constipation is a common side effect of opioid use, diarrhea is not a significant concern compared to respiratory depression.
B: Hypertension - Morphine can cause hypotension rather than hypertension, so monitoring blood pressure for hypertension is not the priority.
D: Increased urine output - Morphine can actually cause urinary retention, so increased urine output is not a key side effect to monitor.
A patient with hyperthyroidism is prescribed propylthiouracil (PTU). What is the primary purpose of this medication?
- A. Increase thyroid hormone production
- B. Suppress thyroid hormone production
- C. Enhance iodine absorption
- D. Stimulate the thyroid gland
Correct Answer: B
Rationale: The correct answer is B: Suppress thyroid hormone production. PTU is an antithyroid medication used to inhibit the synthesis of thyroid hormones, effectively suppressing their production. This helps to manage hyperthyroidism by reducing excessive levels of thyroid hormones in the body. Choices A, C, and D are incorrect as PTU does not aim to increase hormone production, enhance iodine absorption, or stimulate the thyroid gland. Understanding the mechanism of action of PTU is crucial in recognizing its primary purpose in treating hyperthyroidism.