Nokea
A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?
- A. Orthostatic hypotension
- B. Hyperglycemia
- C. Paresthesia
- D. Jaundice
Correct Answer: B
Rationale: The correct answer is B: Hyperglycemia. Prednisone can increase blood sugar levels, and insulin is used to lower blood sugar levels. If the client is experiencing hyperglycemia while taking both medications, it indicates a possible medication interaction. Orthostatic hypotension (A) is not typically associated with this medication combination. Paresthesia (C) and jaundice (D) are not commonly related to prednisone and insulin interactions.
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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.
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.
Vital Signs
History and Physical
Assessment
Laboratory Results
Provider Prescriptions
Yesterday:
Temperature 37.4° C (99.3° F)
Heart rate 92/min
Respiratory rate 18/min
Blood pressure 130/82 mm Hg
Oxygen saturation 97% on room air
Today:
Temperature 38.9° C (102° F) Heart rate 110/min
Respiratory rate 18/min
Blood pressure 138/88 mm Hg
Oxygen saturation 96% on room air
The nurse has reviewed the client's electronic medical record (EMR). Which of the following findings should the nurse recommend withholding the ceftriaxone? Select all that apply.
- A. Breastfeeding
- B. Client allergy
- C. Gentamycin prescription
- D. Hematocrit
- E. Hemoglobin
Correct Answer: B,C
Rationale: The correct answers are B and C.
B: Withholding ceftriaxone is recommended if the client has an allergy to it to prevent an allergic reaction.
C: Gentamicin can interact with ceftriaxone, leading to potential adverse effects.
Incorrect choices:
A: Breastfeeding is not a contraindication for ceftriaxone use.
D and E: Hematocrit and hemoglobin levels are not directly related to the administration of ceftriaxone.
A nurse is caring for a client who has chronic liver disease. Which of the following medications should the nurse recognize as appropriate for this client?
- A. Alprazolam
- B. Rotavirus vaccine
- C. Niacin
- D. Hepatitis A vaccine
Correct Answer: D
Rationale: The correct answer is D: Hepatitis A vaccine. Patients with chronic liver disease are at increased risk for complications from hepatitis A. Administering the hepatitis A vaccine can help prevent further liver damage in this population. Alprazolam (A) is a benzodiazepine used for anxiety disorders, not directly related to liver disease. Rotavirus vaccine (B) is used for preventing rotavirus infection in children, not relevant to chronic liver disease in adults. Niacin (C) is a vitamin used for managing cholesterol levels and has no direct effect on liver disease.
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.