Nokea
A nurse is collecting data from a client who has gout and is taking allopurinol. Which of the following adverse effects should the nurse identify as the priority to report to the provider?
- A. Rash
- B. Diarrhea
- C. Nausea
- D. Metallic taste in mouth
Correct Answer: A
Rationale: The correct answer is A: Rash. A rash could indicate a severe allergic reaction or Stevens-Johnson syndrome, a potentially life-threatening skin disorder associated with allopurinol. This adverse effect requires immediate medical attention to prevent serious complications.
B: Diarrhea, C: Nausea, and D: Metallic taste in mouth are common side effects of allopurinol but not typically considered urgent or life-threatening. Reporting them to the provider is important, but they do not require immediate attention like a rash.
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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.
History and Physical
Medication Administration Record
Vital Signs
1630:
Called to client's room by emergency call bell. Client is alert and oriented to person, place, and time. Client is short of breath, intercostal retractions visible. Wheezing auscultated throughout lung fields. Diffuse, raised rash present on trunk. Abdomen soft. nontender.
A nurse in the emergency department is assisting in the care of a client.
Click to highlight the findings that require immediate follow-up. To deselect a finding click on the finding again.
Nurses Notes
1630:
Called to client's room by emergency call bell. Client is alert and oriented to person, place, and time. Client is short of breath, intercostal retractions visible. Wheezing auscultated throughout lung fields, Diffuse, raised rash present on trunk. Abdomen soft, nontender
Vital Signs
1630:
Temperature 38.3°C (101°F)
Heart rate 110/min
Respiratory rate 30/min
Blood pressure 90/55 mmHg
Oxygen saturation 91% on room air
Click to highlight the findings that require immediate follow-up.
- A. Client is short of breath
- B. Intercostal retractions visible
- C. Wheezing auscultated throughout lung fields
- D. Diffuse, raised rash present on trunk
- E. Respiratory rate 30/min
- F. Blood pressure 90/55 mmHg
- G. Oxygen saturation 91% on room air
Correct Answer: A,B,C,D,E,F,G
Rationale: [ , , , , , , ]
A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?
- A. Diphenhydramine
- B. Docusate sodium
- C. Ibuprofen
- D. Glucosamine
Correct Answer: A
Rationale: The correct answer is A: Diphenhydramine. Haloperidol and diphenhydramine both have sedative effects and can cause additive central nervous system depression when taken together. This can lead to increased drowsiness, confusion, and impaired coordination. Docusate sodium (B), ibuprofen (C), and glucosamine (D) do not have significant interactions with haloperidol. It is important for the client to avoid diphenhydramine to prevent potential adverse effects.
Nurses' Notes
Medication Reconciliation
Medicine Prescriptions
1 week ago:
Client who was diagnosed with asthma during childhood presents to the clinic with increased night-time coughing and shortness of breath during activities of daily living. The client reports increased use of their rescue inhaler. The client has a non-productive cough and inspiratory and expiratory wheezing heard during auscultation. Client prescribed prednisone and requested to follow up in 5 to 7 days.
Today:
The client reports their asthma symptoms have improved since beginning the prednisone. Lung sounds clear with occasional wheezing. The client has gained 1.36 kg (3 lb) since the last visit. The client states they received the "flu shot" 3 days ago to avoid getting sick. The client states they hurt their back while moving the couch 5 days ago and have been taking ibuprofen twice daily since then.
Complete the following sentence by using the lists of options: The client is most at risk for developing ___ due to their ___.
- A. Cushing syndrome
- B. influenza
- C. peptic ulcers
- D. NSAID use
- E. recent immunization
- F. weight gain
Correct Answer: C,D
Rationale:
The correct answer is C,D because the client is at risk for developing peptic ulcers due to NSAID use. NSAIDs can cause irritation and damage to the stomach lining, leading to peptic ulcers. The other options, such as Cushing syndrome (A), influenza (B), recent immunization (E), and weight gain (F), are not directly related to the client's risk of developing peptic ulcers due to NSAID use.
A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should anticipate administering which of the following medications to the client to facilitate the withdrawal process?
- A. Varenicline
- B. Diazepam
- C. Clonidine
- D. Methadone
Correct Answer: B
Rationale: The correct answer is B: Diazepam. Diazepam is a benzodiazepine that is commonly used to manage acute alcohol withdrawal symptoms by reducing anxiety, agitation, and preventing seizures. It acts on the GABA receptors to produce a calming effect. Varenicline (A) is used for smoking cessation, not alcohol withdrawal. Clonidine (C) is mainly used for hypertension and opioid withdrawal, not alcohol withdrawal. Methadone (D) is used for opioid dependence, not alcohol withdrawal.