Nokea
A nurse is providing care to a client with staphylococcus epidermidis who is prescribed vancomycin. Identify the adverse effect associated with the antibiotic therapy.
- A. Hepatotoxicity
- B. Constipation
- C. Infusion reaction
- D. Immunosuppression
Correct Answer: C
Rationale: The correct answer is C: Infusion reaction. Vancomycin can cause infusion reactions like 'Red Man Syndrome,' which involves rashes, flushing, tachycardia, and hypotension. Hepatotoxicity (choice A) is not a common adverse effect of vancomycin. Constipation (choice B) is not typically associated with vancomycin use. Immunosuppression (choice D) is not a direct adverse effect of vancomycin therapy.
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A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?
- A. Osteoporosis
- B. Hypertension
- C. Peptic ulcer disease
- D. Immunosuppression
Correct Answer: C
Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.
A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacologic action of this medication?
- A. To stimulate the pancreas to secrete insulin
- B. To slow the absorption of glucose in the intestine
- C. To increase reabsorption of water in the renal tubules
- D. To increase blood pressure
Correct Answer: C
Rationale: The correct answer is C: To increase reabsorption of water in the renal tubules. Vasopressin, also known as antidiuretic hormone (ADH), works by increasing the reabsorption of water in the renal tubules, which helps to concentrate urine and reduce excessive urination in diabetes insipidus. Choice A is incorrect as vasopressin does not stimulate the pancreas to secrete insulin. Choice B is incorrect as vasopressin does not affect the absorption of glucose in the intestine. Choice D is incorrect as vasopressin's primary action is not to increase blood pressure, although it can have some vasoconstrictive effects.
A healthcare provider is reviewing the client's history before administering opioid pain medication. Which of the following conditions is a contraindication to opioid therapy?
- A. Asthma
- B. Renal failure
- C. Diabetes mellitus
- D. Obesity
Correct Answer: B
Rationale: Renal failure is a contraindication to opioid therapy due to the risk of drug accumulation and toxicity. Asthma, diabetes mellitus, and obesity are not contraindications to opioid therapy. Asthma is a respiratory condition that can be managed alongside opioids, diabetes mellitus and obesity do not directly contraindicate opioid therapy.
A nurse is caring for a client receiving patient-controlled analgesia (PCA). Which of the following interventions should the nurse take while caring for this client?
- A. Advise the client to use the pump sparingly to prevent addiction
- B. Encourage the client to use the PCA before dressing changes
- C. Encourage the client's family to administer PCA while the client is sleeping
- D. Increase the client's 4-hour limit as needed
Correct Answer: B
Rationale: The correct answer is B because encouraging the client to use the PCA before dressing changes helps in managing pain proactively. Choice A is incorrect as PCA is a safe method of pain control when used appropriately, and the nurse should not suggest using it sparingly. Choice C is incorrect as only the client should operate the PCA to ensure they are in control of their pain management. Choice D is incorrect as changing the PCA limit without proper assessment and orders from the healthcare provider can lead to adverse effects.
A healthcare provider is preparing to administer heparin sodium to a client with deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor during therapy?
- A. INR
- B. Serum creatinine
- C. aPTT
- D. Bilirubin
Correct Answer: C
Rationale: The correct answer is C: aPTT. The healthcare provider should monitor the activated partial thromboplastin time (aPTT) value during heparin therapy to assess the client's coagulation status. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure that the client is within the therapeutic range to prevent bleeding or clotting issues. INR (Choice A) is used to monitor warfarin therapy, not heparin. Serum creatinine (Choice B) is not directly related to monitoring heparin therapy. Bilirubin (Choice D) is related to liver function, not heparin therapy.