Nokea
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. Hypoglycemia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypokalemia
Correct Answer: B
Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic and can lead to an increase in potassium levels (hyperkalemia). Lisinopril, an ACE inhibitor, can also contribute to this effect. Monitoring for hyperkalemia is crucial as it can lead to serious cardiac complications.
A: Hypoglycemia is not typically associated with spironolactone or lisinopril.
C: Hyperglycemia is not a common adverse effect of spironolactone or lisinopril.
D: Hypokalemia is unlikely with spironolactone, as it tends to increase potassium levels.
In summary, monitoring for hyperkalemia is essential when a client is taking spironolactone and lisinopril due to the potential for adverse cardiac events.
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A nurse is preparing to administer erythromycin PO to a client who has an infection. The nurse checks the client's medical record and notes that the client has a severe allergy to penicillin. Which of the following actions should the nurse take?
- A. Premedicate the client with diphenhydramine.
- B. Request a different route of administration from the provider.
- C. Administer the medication to the client.
- D. Request a different medication from the provider.
Correct Answer: C
Rationale: Rationale:
The correct action is to administer the medication to the client (Choice C) because erythromycin is not related to penicillin, and having a severe allergy to penicillin does not contraindicate the use of erythromycin. Premedicating with diphenhydramine (Choice A) is not necessary as there is no cross-reactivity between erythromycin and penicillin. Requesting a different route of administration (Choice B) is unnecessary as the oral route is appropriate for erythromycin. Requesting a different medication (Choice D) is not required, as erythromycin is safe to use in a client with a penicillin allergy.
A nurse is caring for a client who has chronic renal failure and is receiving epoetin alfa. To check for therapeutic effects, the nurse should monitor which of the following client laboratory tests?
- A. Hemoglobin levels
- B. Iron levels
- C. Platelet count
- D. White blood cell count
Correct Answer: A
Rationale: The correct answer is A: Hemoglobin levels. Epoetin alfa stimulates red blood cell production, increasing hemoglobin levels in clients with chronic renal failure who often have anemia. Monitoring hemoglobin levels helps assess the effectiveness of the medication. Iron levels (B) are important for erythropoiesis but not directly affected by epoetin alfa. Platelet count (C) and white blood cell count (D) are not specifically related to the therapeutic effects of epoetin alfa in chronic renal failure.
A nurse is reinforcing discharge teaching with a client who has tuberculosis and a prescription for rifampin. Which of the following client statements indicates an understanding of the teaching?
- A. I can discontinue this medication after one negative sputum culture.'
- B. I should take this medication on an empty stomach.'
- C. I should expect to have ringing in my ears.'
- D. I can expect to have joint pain.'
Correct Answer: B
Rationale: The correct answer is B: "I should take this medication on an empty stomach." Rifampin should be taken on an empty stomach to maximize absorption. Taking it with food can decrease its effectiveness. Choice A is incorrect because rifampin treatment typically lasts several months, not just until one negative sputum culture. Choices C and D are incorrect as they are not common side effects of rifampin. The client should be informed about potential side effects, such as gastrointestinal upset or discoloration of bodily fluids, but not ringing in the ears or joint pain.
A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?
- A. A pregnant parent
- B. Receiving treatment for leukemia
- C. Taking acetaminophen for mild discomfort
- D. An allergy to eggs
Correct Answer: B
Rationale: The correct answer is B: Receiving treatment for leukemia. This is because individuals with leukemia have weakened immune systems, making them more susceptible to infections. Administering a live vaccine like varicella could potentially cause severe complications in these individuals.
Incorrect choices:
A: A pregnant parent - Pregnancy is not a contraindication for varicella vaccine.
C: Taking acetaminophen for mild discomfort - Acetaminophen does not interfere with varicella vaccine.
D: An allergy to eggs - Varicella vaccine is made using gelatin, not eggs, so egg allergy is not a contraindication.
A nurse is caring for a client who is receiving filgrastim. The nurse should monitor the client for which of the following adverse effects?
- A. Hypertension
- B. Fluid retention
- C. Bone pain
- D. Hypokalemia
Correct Answer: C
Rationale: The correct answer is C: Bone pain. Filgrastim is a medication that stimulates the production of white blood cells. Bone pain is a common adverse effect because it indicates the bone marrow is producing more cells. Monitoring for bone pain is crucial to assess the effectiveness of the medication. Hypertension (A) and fluid retention (B) are not typically associated with filgrastim. Hypokalemia (D) is not a common adverse effect of filgrastim.