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A nurse is caring for a client who has a new prescription for valproic acid. The nurse should review which of the following baseline laboratory values prior to administering the medication?
- A. Arterial blood gases
- B. Liver function tests
- C. Troponin levels
- D. Blood glucose levels
Correct Answer: B
Rationale: The correct answer is B: Liver function tests. Valproic acid is known to potentially cause hepatotoxicity, so it is essential to assess baseline liver function tests before administering the medication. Monitoring liver function tests can help identify any pre-existing liver conditions and prevent further liver damage. Arterial blood gases (A) are not directly related to valproic acid administration. Troponin levels (C) are used to assess heart muscle damage, which is not a concern with valproic acid. Blood glucose levels (D) are not specifically relevant to valproic acid therapy.
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A nurse is reinforcing teaching with a client who has motion sickness and a new prescription for a transdermal patch of scopolamine. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Diarrhea
- B. Bruising
- C. Jaundice
- D. Drowsiness
Correct Answer: D
Rationale: The correct answer is D: Drowsiness. Scopolamine is an anticholinergic medication commonly used to treat motion sickness. One of the common side effects of anticholinergics is drowsiness. This occurs due to the central nervous system depressant effects of the medication. Monitoring for drowsiness is important as it can impact the client's ability to drive or operate machinery safely.
A: Diarrhea is not a common side effect of scopolamine.
B: Bruising is not a common side effect of scopolamine.
C: Jaundice is not a common side effect of scopolamine.
A nurse is collecting data from a client who takes furosemide daily for heart failure. Which of the following laboratory values should the nurse review before administering the medication?
- A. Erythrocyte sedimentation rate
- B. Thyroxine
- C. Serum potassium
- D. Serum aspartate aminotransferase
Correct Answer: C
Rationale: The correct answer is C: Serum potassium. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia. Monitoring serum potassium levels is crucial to prevent complications such as cardiac arrhythmias. Erythrocyte sedimentation rate (A) is not relevant for assessing furosemide therapy. Thyroxine (B) is a thyroid hormone and not directly affected by furosemide. Serum aspartate aminotransferase (D) is a liver enzyme and not specifically impacted by furosemide administration.
A nurse is caring for a client who started taking amitriptyline 6 days ago. The client reports that the medication is not helping. Which of the following responses should the nurse make?
- A. I will inform your provider so they can prescribe a different medication.
- B. You will need to take this medication on an empty stomach for it to be more effective.
- C. You will need to wait a couple of weeks to feel the therapeutic effect of the medication.
- D. I will ask your provider to increase the dose of the medication.
Correct Answer: C
Rationale: The correct response is C: "You will need to wait a couple of weeks to feel the therapeutic effect of the medication." Amitriptyline, a tricyclic antidepressant, often takes 2-4 weeks to reach its full therapeutic effect. This is due to the time required for the medication to build up in the body and for the brain chemistry to adjust. It is crucial for the nurse to educate the client about this delayed onset of action to manage their expectations and prevent premature discontinuation.
Choices A, B, and D are incorrect because they do not address the pharmacokinetics or expected timeline for amitriptyline to take effect. Informing the provider for a different medication, taking on an empty stomach, or increasing the dose may not be necessary or safe without giving the current medication adequate time to work. The nurse should prioritize patient education on the medication's expected timeline rather than making immediate changes.
A nurse is caring for a client who is postoperative. For which of the following findings should the nurse administer ondansetron?
- A. Client reports nausea.
- B. Client reports incisional pain.
- C. Client's respiratory rate is 14/min.
- D. Client's blood pressure is 110/72 mm Hg.
Correct Answer: A
Rationale: The correct answer is A. Ondansetron is commonly used to treat nausea and vomiting, especially in postoperative clients. Administering ondansetron for nausea can help alleviate the client's discomfort and prevent further complications. Choices B, C, and D do not indicate a need for ondansetron as they are not directly related to nausea. Choice B suggests a need for pain management, choice C indicates normal respiratory rate, and choice D shows a stable blood pressure. Therefore, administering ondansetron would not be appropriate for these findings.
A nurse is caring for a client who has prescriptions for spironolactone and lisinopril. The nurse should monitor for which of the following adverse effects?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Hypokalemia
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to elevated potassium levels (hyperkalemia). Lisinopril is an ACE inhibitor that may also contribute to increased potassium levels. Monitoring for hyperkalemia is essential due to the risk of serious cardiac arrhythmias. Hypoglycemia (choice B) and hyperglycemia (choice D) are not typically associated with these medications. Hypokalemia (choice C) is the opposite of what is expected with spironolactone.