A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?
- A. Increased risk of infection
- B. Bone marrow suppression
- C. Hair loss
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.
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A client with a productive cough and fever has been diagnosed with bacterial pneumonia and is being admitted to the unit from the emergency room. Which intervention should the practical nurse ensure has been done prior to the administration of antibiotics?
- A. Sputum specimen
- B. Set of vital signs
- C. Electrocardiogram
- D. Glucometer check
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is receiving heparin to treat a deep vein thrombosis. The nurse should monitor which laboratory result to assist in evaluating the efficacy of the drug?
- A. Platelet count
- B. Prothrombin time
- C. Partial thromboplastin time
- D. Serum levels of protamine sulfate
Correct Answer: C
Rationale: The nurse should monitor the partial thromboplastin time to evaluate the efficacy of heparin. Partial thromboplastin time reflects the anticoagulant effect of heparin by measuring the intrinsic pathway of coagulation. Platelet count assesses platelet levels and is not specific to heparin efficacy. Prothrombin time is used to monitor warfarin therapy. Serum levels of protamine sulfate are not used to evaluate the efficacy of heparin.
The healthcare provider has administered albuterol as an inhaled medication. The healthcare provider should monitor the client for which possible adverse reaction?
- A. Enuresis
- B. Lethargy
- C. Depression
- D. Tachycardia
Correct Answer: D
Rationale: Albuterol is a bronchodilator in the adrenergic category. Its actions and adverse effects are similar to adrenaline or epinephrine. The healthcare provider should monitor the client for tachycardia, which is a common adverse effect of albuterol due to its stimulant effect on beta-2 receptors. Enuresis, or night bed-wetting, is not an adverse effect associated with albuterol. Additionally, the client should be monitored for anxiety as a potential adverse effect, not lethargy or depression, which are not typically associated with albuterol administration.
When planning to administer the antiulcer GI agent sucralfate, what instruction should the nurse provide regarding administration?
- A. Administer sucralfate once a day
- B. Assess for secondary candida infection
- C. Monitor electrolyte imbalance
- D. Give sucralfate on an empty stomach
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client prescribed glipizide asked why they had to take their insulin orally. How should the practical nurse respond?
- A. Glipizide is not an oral form of insulin and can be used only when some beta cell function is present.
- B. Glipizide is an oral form of insulin and is distributed, metabolized, and excreted in the same manner as insulin.
- C. Glipizide is an oral form of insulin and has the same actions and properties as intermediate insulin.
- D. Glipizide is not an oral form of insulin, but it is effective for those who are resistant to injectable insulins.
Correct Answer: A
Rationale: The practical nurse should explain to the client that glipizide is not an oral form of insulin but an oral hypoglycemic agent. Glipizide works by enhancing pancreatic production of insulin when some beta cell function is present. It is not a replacement for insulin but helps the body produce more insulin. Therefore, it can be used when there is still some beta cell function present, unlike insulin which is used when there is a deficiency of endogenous insulin production.
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