Nokea
A nurse is caring for a client who is receiving tobramycin. The nurse should monitor the client for which of the following adverse effects?
- A. Increased salivation
- B. Bruising
- C. Joint pain
- D. Tinnitus
Correct Answer: D
Rationale: The correct answer is D: Tinnitus. Tobramycin is an aminoglycoside antibiotic known to cause ototoxicity, including tinnitus. Tinnitus is a ringing or buzzing sound in the ears. It is important to monitor for this adverse effect as it can be an early sign of ototoxicity. Increased salivation (A), bruising (B), and joint pain (C) are not commonly associated with tobramycin use. Monitoring for tinnitus is crucial to prevent further hearing loss.
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A nurse in a clinic receives a telephone call from a client who has tuberculosis and was prescribed rifampin 3 days ago. The client reports, 'My saliva and tears are red. What should I do?' Which of the following responses by the nurse is appropriate?
- A. This is an expected adverse effect of the medication.'
- B. Stop taking the medication. You are having an allergic reaction.'
- C. This condition will only last a couple of days.'
- D. Taking the medication with red meat will cause this adverse effect.'
Correct Answer: A
Rationale: The correct response is A: "This is an expected adverse effect of the medication." Red discoloration of bodily fluids is a known side effect of rifampin. The medication can cause harmless discoloration of saliva, tears, sweat, and urine. It does not indicate an allergic reaction or a serious issue that requires stopping the medication. Choice B is incorrect as stopping the medication abruptly is not necessary. Choice C is incorrect as the duration of this side effect varies. Choice D is incorrect as the discoloration is not related to the consumption of red meat.
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.
A nurse is caring for a client who reports difficulty breathing during the administration of an intermittent IV bolus of nafcillin. After stopping the infusion and notifying the provider, the nurse should anticipate a prescription for which of the following medications?
- A. Deferoxamine
- B. Vitamin K
- C. Epinephrine
- D. Prednisone
Correct Answer: C
Rationale: The correct answer is C: Epinephrine. This medication is indicated for the treatment of anaphylaxis, a severe allergic reaction that can cause difficulty breathing. Given the client's symptoms of difficulty breathing during the IV bolus administration of nafcillin, an allergic reaction is a likely cause. Epinephrine is the first-line treatment for anaphylaxis as it works quickly to constrict blood vessels, relax smooth muscles in the airways, and improve breathing. Deferoxamine (A) is used for iron toxicity, Vitamin K (B) for coagulation disorders, and Prednisone (D) for inflammation, none of which are indicated for this client's symptoms.
A nurse is reinforcing teaching with a client who has a new prescription for alendronate for the treatment of osteoporosis. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Anorexia
- B. Jaw pain
- C. Insomnia
- D. Bruising
Correct Answer: B
Rationale: The correct answer is B: Jaw pain. Alendronate, a bisphosphonate medication used to treat osteoporosis, can cause a rare but serious side effect called osteonecrosis of the jaw (ONJ), characterized by jaw pain, swelling, and possible infection. It is essential for the nurse to instruct the client to monitor for any signs of jaw pain to promptly report to their healthcare provider. Anorexia (A), insomnia (C), and bruising (D) are not typically associated with alendronate use for osteoporosis and would not be common adverse effects that the client needs to monitor for.
Nurses' Notes
Vital Signs
Laboratory Results
0800:
Client is admitted with a 3-day history of abdominal cramps and diarrhea of 4 to 5 liquid stools per day.
Client was taking amoxicillin/clavulanate 875 mg PO every 12 hr for 10 days for a respiratory tract infection. Antibiotics completed 7 days ago.
Bilateral breath sounds clear and present throughout.
Abdomen soft, distended with hyperactive bowel sounds audible in all 4 quadrants.
Stool is watery and contains mucous. Stool sent for culture.
A nurse is assisting in the care of a female client.
Complete the following sentence by using the lists of options: The nurse should first address the client ___ followed by the client's ___.
- A. blood pressure
- B. Hgb level
- C. temperature
- D. potassium level
- E. abdominal findings
- F. Hct level
Correct Answer: A,D
Rationale: Sure, here is the detailed explanation for the correct answer :
1. **Blood pressure (A)**: The nurse should first address the client's blood pressure as it is a vital sign that provides immediate information about the client's cardiovascular health and overall perfusion status.
2. **Potassium level (D)**: Following the assessment of blood pressure, addressing the client's potassium level is important as potassium imbalances can have critical implications on cardiac function and require prompt intervention.
**Summary**:
- **Incorrect Choices**:
- B: Hgb level and F: Hct level are related to blood components and not typically the first priority in a general assessment.
- C: Temperature is important but may not be the immediate priority compared to blood pressure and potassium level.
- E: Abdominal findings are important but may not be the initial focus in this context.
- **Correct Choices**:
- A: Blood pressure and D: Potassium level are crucial in