Nokea
A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?
- A. A client with a history of deep-vein thrombosis
- B. A client with a history of migraine headaches
- C. A client with a history of hypertension
- D. A client with a history of anemia
Correct Answer: A
Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.
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A client has a new prescription for Clopidogrel. Which of the following instructions should the nurse include?
- A. Take this medication with food.
- B. Avoid taking aspirin while on this medication.
- C. Avoid eating foods high in potassium.
- D. Take this medication at bedtime.
Correct Answer: B
Rationale: The correct answer is B: 'Avoid taking aspirin while on this medication.' Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs also affect platelet function and can further increase the risk of bleeding when combined with Clopidogrel. Therefore, it is important for the client to avoid taking aspirin while on this medication to reduce the risk of excessive bleeding. Choices A, C, and D are incorrect because there is no specific requirement to take Clopidogrel with food, avoid foods high in potassium, or take it at bedtime. The key instruction here is to avoid aspirin to prevent potential bleeding complications.
When providing teaching to a client with a prescription for Hydrochlorothiazide, which instruction should the nurse include?
- A. Take this medication at bedtime.
- B. Avoid foods high in potassium.
- C. Take this medication on an empty stomach.
- D. Monitor for signs of dehydration.
Correct Answer: D
Rationale: The correct instruction for a client prescribed Hydrochlorothiazide is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and electrolyte imbalance, potentially causing dehydration. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. Therefore, it is essential for the client to be vigilant in recognizing these symptoms and seek medical attention if they occur. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide at bedtime is not a specific instruction related to its effects or side effects. Avoiding foods high in potassium may be necessary for some medications, but it is not the primary concern with Hydrochlorothiazide. Taking this medication on an empty stomach is not a requirement and may vary depending on individual preferences or healthcare provider instructions.
A client with brain cancer and headaches is prescribed dexamethasone. What is the purpose of this adjuvant medication?
- A. To decrease inflammation and swelling
- B. To improve concentration
- C. To induce sedation
- D. To treat depression
Correct Answer: A
Rationale: Dexamethasone, a glucocorticoid, is indicated for clients with brain cancer to decrease inflammation and swelling. It helps reduce cerebral edema and relieve pressure caused by the tumor, ultimately alleviating headaches. The purpose of prescribing dexamethasone in this case is not to improve concentration (choice B), induce sedation (choice C), or treat depression (choice D). Methylphenidate, a stimulant, is used for conditions like ADHD, not for brain cancer. Hydroxyzine, an antihistamine, is primarily used for anxiety and itching, not for brain cancer. Amitriptyline, a tricyclic antidepressant, is used for conditions like depression and neuropathic pain, not specifically for brain cancer-related headaches.
A healthcare professional is caring for a client who has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the healthcare professional perform first?
- A. Urine output
- B. Bowel sounds
- C. Pain level
- D. Respiratory rate
Correct Answer: D
Rationale: The healthcare professional should prioritize assessing the client's respiratory rate because respiratory depression is a life-threatening adverse effect of Morphine. Monitoring the respiratory rate allows for early detection of potential complications and timely intervention to prevent harm. Assessing urine output, bowel sounds, and pain level are important but should come after ensuring the client's respiratory status is stable as it is the most critical assessment to prevent serious complications associated with opioid use.
A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take the medication before bed.
- B. Monitor for increased blood pressure.
- C. Take the medication on an empty stomach.
- D. Monitor for leg cramps.
Correct Answer: D
Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.