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A client with rheumatoid arthritis is prescribed methotrexate. Which laboratory value should the nurse monitor?
- A. Liver function tests.
- B. Serum glucose.
- C. Hemoglobin A1c.
- D. Serum calcium.
Correct Answer: A
Rationale: Methotrexate can cause hepatotoxicity, so monitoring liver function tests is essential.
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The nurse is delivering care to a client who is diagnosed with toxic shock syndrome (TSS). Which complication of this syndrome should the nurse monitor the client for?
- A. Pulmonary embolism
- B. Vitamin K deficiency
- C. Factor VIII deficiency
- D. Disseminated intravascular coagulopathy (DIC)
Correct Answer: D
Rationale: TSS is caused by infection and is often associated with tampon use. DIC is a complication of TSS. The nurse monitors the client for signs of this complication, and notifies the primary health care provider promptly if signs and symptoms are noted. The other options are not complications of TSS.
The nurse is caring for a client with a suspected stroke. Which assessment should the nurse perform first?
- A. Check blood glucose levels
- B. Assess pupil response
- C. Evaluate speech and motor function
- D. Monitor blood pressure
Correct Answer: C
Rationale: Evaluating speech and motor function first helps confirm stroke symptoms using tools like the FAST scale, guiding urgent intervention.
The client received electroconvulsive therapy (ECT) an hour ago and tells the nurse that he has a headache. Which response by the nurse is best?
- A. A headache is common after ECT.
- B. I will get some acetaminophen (Tylenol) for you.
- C. A nap will help you feel better.
- D. A tapur command and then let me know how you feel.
Correct Answer: B
Rationale: Offering acetaminophen addresses the client's complaint directly and safely, as headaches are a common side effect of ECT. Informing the client that headaches are common does not provide relief, and a nap or unclear commands are not appropriate responses.
A client has started taking amiodarone (Cordarone). The nurse should inform the client that periodic laboratory tests will be done to monitor the client's:
- A. Hemoglobin.
- B. Liver enzymes.
- C. Creatine kinase (CK) concentration.
- D. Renal function.
Correct Answer: B
Rationale: Amiodarone can cause hepatotoxicity, so periodic monitoring of liver enzymes is necessary to detect potential liver damage.
A client has been hospitalized with heart failure. He is receiving digoxin (Lanoxin) and furosemide (Lasix) intravenously. He tells the nurse that he hears a continuous ringing in his ears and that he has never had this problem before. What is the appropriate action for the nurse to take at this time?
- A. Obtain a digoxin level to check for toxicity
- B. Note the observation in the chart and plan to reassess in 2 hours
- C. Ask the client if he has been taking aspirin in addition to his other medications
- D. Discontinue the furosemide and notify the physician
Correct Answer: A
Rationale: Ringing in the ears (tinnitus) is a sign of digoxin toxicity, requiring immediate checking of digoxin levels. Aspirin is less likely to cause this, and discontinuing furosemide or delaying action is inappropriate.