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A healthcare professional is reviewing laboratory results for a client with rheumatoid arthritis prescribed methotrexate. Which of the following laboratory results should the healthcare professional report to the provider?
- A. WBC count 1,200/mm³
- B. Hemoglobin 14 g/dL
- C. Platelets 150,000/mm³
- D. Blood glucose 110 mg/dL
Correct Answer: A
Rationale: A WBC count of 1,200/mm³ indicates leukopenia, a serious side effect of methotrexate that can lead to increased risk of infections. It is crucial to report this finding promptly to the provider for further evaluation and possible adjustments in the treatment plan. Choices B, C, and D are within normal ranges and do not represent significant concerns related to methotrexate therapy in this context.
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During an assessment, a client taking valproic acid exhibits elevated liver enzymes. What finding should the nurse report to the provider?
- A. Elevated liver enzymes
- B. Weight loss
- C. Dry mouth
- D. Increased appetite
Correct Answer: A
Rationale: Elevated liver enzymes are a critical finding that the nurse should report to the provider when assessing a client taking valproic acid. It can be indicative of hepatotoxicity, a severe side effect associated with valproic acid use. Timely reporting and intervention are essential to prevent further complications and ensure the client's safety and well-being. Choices B, C, and D are not directly related to valproic acid use or the manifestation of hepatotoxicity. Weight loss, dry mouth, and increased appetite are not typically associated with elevated liver enzymes in the context of valproic acid administration.
When teaching a client about the adverse effects of simvastatin, which of the following findings should be included as an adverse effect?
- A. Tinnitus
- B. Muscle pain
- C. Diarrhea
- D. Facial flushing
Correct Answer: B
Rationale: Muscle pain should be included as an adverse effect when teaching a client about simvastatin. It can be a sign of rhabdomyolysis, a severe side effect associated with statins like simvastatin that involves muscle breakdown. Monitoring for muscle pain is crucial to prevent serious complications and ensure timely intervention. Tinnitus, diarrhea, and facial flushing are not typically associated with simvastatin use and are less common adverse effects compared to muscle pain.
A healthcare professional is preparing to administer a unit of packed red blood cells to a client. Which of the following actions should the healthcare professional take?
- A. Prime the blood tubing with normal saline.
- B. Verify the client's identity using two identifiers.
- C. Infuse the blood rapidly over 30 minutes.
- D. Obtain the client's vital signs every 4 hours during the transfusion.
Correct Answer: B
Rationale: Verifying the client's identity using two identifiers is a critical patient safety measure to ensure the correct patient receives the blood transfusion. This process involves checking the patient's identity using at least two unique identifiers, such as name, date of birth, or medical record number, to prevent administration errors. Priming the blood tubing with normal saline is necessary to ensure there are no air bubbles in the tubing, but it is not the immediate action required before administering the blood. Infusing packed red blood cells over 30 minutes is generally too rapid and can lead to adverse reactions; a slower rate is recommended for safe administration. Obtaining vital signs every 4 hours during the transfusion is not frequent enough to monitor the client adequately for potential transfusion reactions or complications; vital signs should be monitored more frequently, especially during the initial phase of the transfusion.
A client has a new prescription for nitroglycerin. Which of the following instructions should the nurse include?
- A. Store the medication in a cool, dry place.
- B. Take the medication as directed by the healthcare provider.
- C. Take the medication 30 minutes before meals.
- D. Take the medication at the first sign of chest pain.
Correct Answer: D
Rationale: Instructing the client to take nitroglycerin at the first sign of chest pain is crucial for immediate relief of angina symptoms. Nitroglycerin is a fast-acting medication that helps dilate blood vessels, improving blood flow to the heart muscle. Therefore, prompt administration at the onset of chest pain is essential to alleviate anginal episodes effectively. Choices A, B, and C are incorrect because storing the medication properly, taking it as directed, or before meals are not specific instructions for managing acute anginal episodes, which require immediate action for symptom relief.
A healthcare professional is assessing a client who has been taking levodopa/carbidopa for Parkinson's disease. Which of the following findings should the healthcare professional report to the provider?
- A. Dry mouth
- B. Urinary retention
- C. Bradykinesia
- D. Dizziness
Correct Answer: C
Rationale: Bradykinesia is a cardinal symptom of Parkinson's disease characterized by slowness of movement. An increase in bradykinesia may indicate a decline in the client's condition and the need for adjustments in their medication regimen. Therefore, the healthcare professional should promptly report this finding to the provider for further evaluation and management. Choices A, B, and D are not directly related to the client's Parkinson's disease or the medication levodopa/carbidopa. Dry mouth is a common side effect of many medications, including anticholinergics, but not specifically levodopa/carbidopa. Urinary retention and dizziness are also not typically associated with levodopa/carbidopa use for Parkinson's disease.