A healthcare professional is educating a client who is beginning therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?
- A. Dyspnea
- B. Constipation
- C. Tinnitus
- D. Dry mouth
Correct Answer: A
Rationale: The correct answer is dyspnea. Dyspnea can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Prompt reporting of dyspnea allows for timely evaluation and management to prevent potential complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings that the client should report.
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A client has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the nurse perform first?
- A. Urine output
- B. Bowel sounds
- C. Pain level
- D. Respiratory rate
Correct Answer: D
Rationale: The nurse should prioritize assessing the client's respiratory rate first when administering Morphine due to the risk of respiratory depression, which is a life-threatening adverse effect of this medication. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress early and take prompt action to ensure the client's safety. Assessing urine output, bowel sounds, and pain level are also important but not as critical as monitoring respiratory rate when initiating Morphine therapy.
A healthcare provider is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare provider plan to take?
- A. Administer IM Enoxaparin along with the Alteplase dose.
- B. Hold direct pressure on puncture sites for up to 30 minutes.
- C. Administer Aminocaproic acid IV prior to alteplase infusion.
- D. Prepare to administer Alteplase within 8 hours of manifestation onset.
Correct Answer: B
Rationale: When administering IV Alteplase for a massive Pulmonary Embolism, the healthcare provider should plan to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This is crucial to prevent bleeding complications at the puncture sites. Choice A is incorrect because Enoxaparin is not usually administered along with Alteplase for a Pulmonary Embolism. Choice C is incorrect because Aminocaproic acid is not typically given prior to alteplase infusion in this situation. Choice D is incorrect because Alteplase should be administered within 2 hours of onset of manifestations for Pulmonary Embolism, not within 8 hours.
A client has a prescription for Nitroglycerin, and a nurse is providing teaching. Which of the following instructions should the nurse include?
- A. Take one tablet every 15 minutes until pain is relieved.
- B. Take one tablet every 5 minutes, up to three doses.
- C. Take one tablet at bedtime.
- D. Take one tablet on an empty stomach.
Correct Answer: B
Rationale: The correct instruction for taking Nitroglycerin is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. Option A is incorrect because taking a tablet every 15 minutes until pain is relieved may lead to delayed intervention. Option C is incorrect as taking Nitroglycerin at bedtime is not indicated for chest pain. Option D is incorrect as Nitroglycerin should be taken sublingually at the onset of chest pain, not on an empty stomach.
A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. Increase your intake of calcium-rich foods.
- C. Brush and floss your teeth regularly.
- D. Avoid eating foods high in potassium.
Correct Answer: C
Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.
A client has a prescription for Nitroglycerin. Which of the following instructions should the nurse include?
- A. Take one tablet every 15 minutes until pain is relieved.
- B. Take one tablet every 5 minutes, up to three doses.
- C. Take one tablet at bedtime.
- D. Take one tablet on an empty stomach.
Correct Answer: B
Rationale: The correct administration of Nitroglycerin involves taking one tablet at the onset of chest pain, then another tablet every 5 minutes for up to three doses. This protocol aims to relieve angina symptoms. Choice A is incorrect because waiting 15 minutes between doses may delay symptom relief. Choice C is incorrect as Nitroglycerin is not typically taken at bedtime but rather during angina episodes. Choice D is incorrect because Nitroglycerin is usually taken sublingually, so it doesn't need to be taken on an empty stomach.