Nokea
A client with rheumatoid arthritis is prescribed adalimumab. What instruction should the nurse include in the client's teaching plan?
- A. Avoid live vaccines while taking this medication.
- B. Take this medication with food to decrease gastrointestinal upset.
- C. Report any signs of infection to the healthcare provider.
- D. Avoid sunlight exposure while taking this medication.
Correct Answer: A
Rationale: The correct instruction for a client prescribed adalimumab, which is an immunosuppressant medication, is to avoid live vaccines. Adalimumab can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent complications and ensure the effectiveness of the treatment.
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A client with hypertension is prescribed lisinopril. The nurse should monitor for which potential side effect?
- A. Dry cough
- B. Hyperkalemia
- C. Hypernatremia
- D. Hyponatremia
Correct Answer: A
Rationale: The correct answer is A: Dry cough. Lisinopril, an ACE inhibitor, is known to cause a persistent dry cough as a common side effect. Monitoring for this adverse effect is crucial because it may lead to non-adherence to the medication. Hyperkalemia (choice B) is a potential side effect of potassium-sparing diuretics, not ACE inhibitors like lisinopril. Hypernatremia (choice C) refers to elevated sodium levels and is not a common side effect of lisinopril. Hyponatremia (choice D) is a condition characterized by low sodium levels and is not a typical side effect of lisinopril. Therefore, the nurse should focus on assessing the client for a dry cough when taking lisinopril.
A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?
- A. Increased appetite
- B. Dry mouth and increased thirst
- C. Tremors and polyuria
- D. Constipation
Correct Answer: B
Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.
A client is prescribed clopidogrel. The nurse should monitor for which potential side effect of this medication?
- A. Nausea and vomiting
- B. Bleeding or bruising
- C. Gastrointestinal bleeding
- D. Fatigue
Correct Answer: C
Rationale: When a client is prescribed clopidogrel, the nurse should monitor for potential side effects related to bleeding due to its antiplatelet effect. Gastrointestinal bleeding is a severe side effect associated with clopidogrel use. Monitoring for signs of gastrointestinal bleeding, such as black, tarry stools or vomiting blood, is essential to prevent serious complications.
While a client is receiving the medication haloperidol, which client data would indicate to the practical nurse that the medication is therapeutic?
- A. The client has maintained consistent weight loss of 2 pounds per week.
- B. The client has demonstrated a decrease in paranoid behaviors.
- C. The client's blood pressure has remained within normal limits.
- D. The client's fasting blood glucose has remained below 120 mg/dL.
Correct Answer: B
Rationale: When a client is taking haloperidol, a therapeutic response involves a decrease in symptoms such as paranoia, hallucinations, delusions, and emotional excitement. These improvements indicate that the medication is effectively managing the client's condition. Monitoring for a reduction in paranoid behaviors helps the practical nurse assess the medication's effectiveness in addressing the client's psychiatric symptoms.
The practical nurse is assigned a client on digoxin therapy. Which finding is likely to predispose this client to developing digoxin toxicity?
- A. Hyponatremia
- B. Hypernatremia
- C. Hyperkalemia
- D. Hypokalemia
Correct Answer: D
Rationale: Hypokalemia predisposes a client on digoxin to digoxin toxicity. Symptoms of digoxin toxicity include abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and atrioventricular (AV) dissociation. Therefore, assessment of serum potassium levels and prompt correction of hypokalemia are crucial interventions for clients taking digoxin.