A client with rheumatoid arthritis is prescribed tofacitinib. What 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 while taking this medication.
Correct Answer: A
Rationale: Tofacitinib is an immunosuppressive medication used in rheumatoid arthritis. Patients taking tofacitinib should avoid live vaccines because the medication can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent any complications related to live vaccines during their treatment.
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A client with a history of heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypernatremia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to an excess of potassium in the body, causing hyperkalemia. This medication inhibits the action of aldosterone, leading to decreased potassium excretion and potential retention. Monitoring potassium levels is essential to prevent complications such as cardiac arrhythmias, especially in clients with heart failure.
A client is receiving levothyroxine for hypothyroidism. The nurse should monitor the client for which potential side effect?
- A. Weight gain
- B. Dry skin
- C. Hair loss
- D. Hyperthermia
Correct Answer: A
Rationale: Levothyroxine is a medication used to treat hypothyroidism by supplementing the body with thyroid hormone. If the dosage of levothyroxine is too high, it can cause symptoms of hyperthyroidism, including weight loss. Therefore, weight gain can be a potential side effect of levothyroxine if the dosage is excessive.
In the emergency department, a child is admitted for accidental ingestion of a poison. The practical nurse (PN) should know that inducing vomiting is recommended for which child?
- A. An 8-month-old who ingested four to six ibuprofen tablets
- B. A 3-year-old who drank an unknown amount of charcoal lighter fluid
- C. A 16-month-old who ingested 2 ounces of acetaminophen elixir
- D. A 2-year-old who ate a handful of automatic dishwasher detergent
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which assessment finding requires nursing intervention prior to the administration of medication?
- A. Apical pulse heard best at the pulmonic site
- B. Irregular apical pulse rhythm
- C. Presence of a systolic heart murmur
- D. Apical pulse rate of 50 beats/minute
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed salmeterol. The nurse should monitor for which potential side effect?
- A. Dry mouth
- B. Tachycardia
- C. Insomnia
- D. Increased appetite
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.