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A nurse is collecting data from a client who has been taking carbamazepine. Which of the following is an adverse effect of carbamazepine and should be reported to the provider?
- A. Sore throat
- B. Increased salivation
- C. Urge incontinence
- D. Gingivitis
Correct Answer: A
Rationale: The correct answer is A: Sore throat. Carbamazepine can cause agranulocytosis, a serious condition characterized by a decrease in white blood cells, leading to symptoms like sore throat. This is a potentially life-threatening adverse effect that should be reported to the provider immediately. Increased salivation (choice B), urge incontinence (choice C), and gingivitis (choice D) are not common adverse effects of carbamazepine and do not require immediate reporting.
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A nurse in a mental health facility is collecting data from a client taking lithium. Which of the following information should the nurse report to the provider as an indication of lithium toxicity?
- A. Dry cough
- B. Elevated blood pressure
- C. Stooped posture
- D. Slurred speech
Correct Answer: D
Rationale: The correct answer is D: Slurred speech. Lithium toxicity can manifest as neurological symptoms such as slurred speech due to its effects on the central nervous system. A dry cough (A) is not typically associated with lithium toxicity. Elevated blood pressure (B) may be a sign of other conditions but is not specific to lithium toxicity. Stooped posture (C) is more indicative of musculoskeletal issues rather than lithium toxicity. In summary, slurred speech is a key neurological symptom of lithium toxicity, making it the correct choice in this scenario.
A nurse is caring for a client who has a prescription for morphine 4 mg IM stat. The medication is dispensed in a 5 mg/mL prefilled syringe. Which of the following actions should the nurse take?
- A. Dispose of the excess medication in the sharps container.
- B. Give the full contents of the prefilled syringe.
- C. Discard the excess medication with a second nurse as a witness.
- D. Inject the prescribed dose and save the rest for a later use.
Correct Answer: C
Rationale: The correct answer is C: Discard the excess medication with a second nurse as a witness. The nurse should discard the excess medication in the presence of another nurse to ensure proper disposal and avoid any medication errors or potential harm to the patient. This action aligns with medication safety practices and helps prevent medication errors.
Choice A: Disposing of the excess medication in the sharps container is incorrect because it does not involve a witness for proper disposal and may not follow facility protocols.
Choice B: Giving the full contents of the prefilled syringe would result in administering more medication than prescribed, risking harm to the patient.
Choice D: Injecting the prescribed dose and saving the rest for later use is incorrect as it goes against safe medication practices and may lead to errors in dosing.
In summary, choice C is the correct action to ensure safe and appropriate disposal of excess medication, while the other choices may lead to potential errors and harm to the patient.
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 reinforcing teaching with a client who has a new prescription for nitroglycerin transdermal patches to treat angina. The nurse should inform the client that which of the following manifestations is an adverse effect of the medication?
- A. Headache
- B. Polyuria
- C. Ringing in the ears
- D. Increased blood pressure
Correct Answer: A
Rationale: The correct answer is A: Headache. Nitroglycerin transdermal patches can cause headaches as an adverse effect due to vasodilation leading to increased blood flow to the brain. This is a common side effect that may occur in patients using nitroglycerin. Polyuria (B) and ringing in the ears (C) are not common side effects of nitroglycerin. Increased blood pressure (D) is not an adverse effect of nitroglycerin; in fact, nitroglycerin decreases blood pressure by dilating blood vessels.
A nurse in an influenza clinic is collecting data from four clients. Which of the following clients should the nurse identify as having a contraindication for receiving the live attenuated form of the influenza vaccine?
- A. An adolescent who received a new tattoo last week
- B. A client is at 27 weeks of gestation
- C. A client who is about to travel to a different country
- D. A school-age child who has rhinitis
Correct Answer: B
Rationale: The correct answer is B - A client at 27 weeks of gestation. Pregnant individuals are contraindicated to receive live attenuated influenza vaccine due to theoretical risk to the fetus. This is because live vaccines are not recommended during pregnancy. Choice A is incorrect as a recent tattoo does not contraindicate the vaccine. Choice C is incorrect as travel plans do not affect the decision to administer the vaccine. Choice D is incorrect as rhinitis is not a contraindication.