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A nurse is caring for a client who has been taking epoetin alfa for 3 months. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication?
- A. Troponin
- B. Thyroxine (T4)
- C. Aspartate aminotransferase (AST)
- D. Hgb
Correct Answer: D
Rationale: The correct answer is D: Hgb (hemoglobin). Epoetin alfa is a medication used to stimulate red blood cell production. Monitoring hemoglobin levels is crucial to assess the effectiveness of the medication in increasing red blood cell count. Hemoglobin reflects the oxygen-carrying capacity of red blood cells, indicating if the medication is addressing the underlying anemia. Troponin (A) is used to assess heart muscle damage, not relevant in this case. Thyroxine (B) reflects thyroid function, not related to epoetin alfa therapy. Aspartate aminotransferase (AST) (C) is a liver enzyme, not relevant for monitoring this medication's efficacy.
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A nurse is reinforcing teaching about phenytoin with a client who had a tonic-clonic seizure. Which of the following information should the nurse include in the teaching?
- A. Taking ginkgo biloba increases phenytoin levels.
- B. Taking phenytoin diminishes potassium levels.
- C. Monitor for gingival hyperplasia.
- D. Minimize exposure to sunlight.
Correct Answer: C
Rationale: The correct answer is C: Monitor for gingival hyperplasia. This is important because phenytoin can cause gingival overgrowth, leading to oral health issues. The nurse should educate the client to maintain good oral hygiene and visit the dentist regularly for check-ups.
A: Taking ginkgo biloba increases phenytoin levels - This statement is incorrect. Ginkgo biloba is known to interact with certain medications, but it does not specifically increase phenytoin levels.
B: Taking phenytoin diminishes potassium levels - This statement is incorrect. Phenytoin does not directly affect potassium levels. It is more likely to cause issues with calcium and vitamin D metabolism.
D: Minimize exposure to sunlight - This statement is incorrect. While some antiepileptic medications can increase sensitivity to sunlight, phenytoin is not typically associated with this side effect.
Overall, monitoring for gingival hyperplasia is the most relevant information for the client
A nurse is reinforcing teaching with a client who has a new prescription for sustained-release verapamil. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will crush the tablet to make it easier to swallow.
- B. I will increase my daily intake of fiber and fluid.
- C. I will follow up with monthly laboratory tests to check for anemia.
- D. I will sit upright for 30 minutes after taking the medication.
Correct Answer: B
Rationale: The correct answer is B: I will increase my daily intake of fiber and fluid. This response indicates understanding because sustained-release verapamil can cause constipation as a side effect. Increasing fiber and fluid intake can help prevent constipation and promote proper bowel function. Crushing sustained-release tablets can alter the drug's intended release mechanism, leading to potential overdose or underdose. Following up with monthly laboratory tests for anemia is not directly related to verapamil therapy. Sitting upright after taking the medication is more relevant for bisphosphonates to prevent esophageal irritation.
A nurse is preparing to administer enoxaparin 5 mg/kg subcutaneous daily to a client who has deep-vein thrombosis. The client weighs 152 lb. Available is 120 mg/0.8 mL prefilled syringe. Calculate the dosage in mL that the nurse should administer. (Round the answer to the nearest tenth. Use a leading zero if applicable. Do not use a trailing zero.)
- A. 0.7
Correct Answer: A
Rationale: To calculate the dosage in mL, first convert the client's weight from pounds to kilograms: 152 lb ÷ 2.2 = 69.1 kg. Then, multiply the weight by the dose (5 mg/kg): 69.1 kg x 5 mg/kg = 345.5 mg. Next, determine the volume needed by dividing the dose by the concentration (120 mg/0.8 mL): 345.5 mg ÷ 120 mg/0.8 mL = 2.3 mL. Round to the nearest tenth, giving 2.3 mL. The correct answer is A (0.7 mL) because 2.3 mL is incorrectly rounded. Other choices are incorrect due to incorrect calculations or rounding.
A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The nurse should identify which of the following findings as an indication of a febrile nonhemolytic reaction?
- A. Dyspnea
- B. Urticaria
- C. Chills
- D. Vomiting
Correct Answer: C
Rationale: The correct answer is C: Chills. A febrile nonhemolytic reaction during a blood transfusion is characterized by the sudden onset of chills and fever, usually within the first 15 minutes to 2 hours of the transfusion. This reaction is caused by the recipient's antibodies reacting to donor leukocytes. Dyspnea (A), urticaria (B), and vomiting (D) are more indicative of other transfusion reactions such as an allergic reaction, hemolytic reaction, or bacterial contamination, respectively.
Vital Signs
Nurses' Notes
History and Physical
Initial visit:
Temperature 36.5° C (97.7° F)
Heart rate 68/min
Blood pressure 116/70 mm Hg
Respiratory rate 16/min
SpO2 98% on room air
Follow-up visit 2 weeks later:
Temperature 36.7° C (98.1° F)
Heart rate 86/min
Blood pressure 130/80 mm Hg
Respiratory rate 18/min.
SpO2 99% on room air
Select the 6 statements the nurse should include when reinforcing teaching to the client about the newly prescribed medication.
- A. This medication should start to alleviate the headache within 1 hour.
- B. You might experience a feeling of pressure in your chest after taking this medication.
- C. Do not take more than 200 milligrams of this medication within 24 hours.
- D. You can take a second dose of this medication at least 2 hours after the initial dose if the headache persists.
- E. You should discontinue this medication if pregnancy is planned or suspected.
- F. This medication can cause you to feel tired.
- G. You might experience a rash on your skin while taking this medication.
Correct Answer: A,B,C,D,E,F
Rationale: The correct answer includes statements covering various important aspects of the medication. A: Ensures client knows when to expect relief. B: Alerts to potential side effect. C: Provides clear dosing instructions. D: Instructs on when and how to take a second dose. E: Important for safety during pregnancy. F: Warns about potential side effect. Explanations for incorrect choices: G: Not as crucial as the other statements.