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A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication?
- A. Improved peripheral vasodilation
- B. Neutralized gastric acid
- C. Increased WBC count
- D. Reduced bronchial inflammation
Correct Answer: D
Rationale: The correct answer is D: Reduced bronchial inflammation. Montelukast is a leukotriene receptor antagonist used to manage asthma and allergic rhinitis by reducing inflammation and bronchoconstriction in the airways. This improves breathing and reduces symptoms. Option A is incorrect as montelukast does not affect peripheral vasodilation. Option B is incorrect as it does not neutralize gastric acid. Option C is incorrect as montelukast does not affect white blood cell count. In summary, montelukast's main therapeutic effect is reducing bronchial inflammation, making option D the correct choice.
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A nurse is caring for a client who has a new prescription for valproic acid. The nurse should review which of the following baseline laboratory values prior to administering the medication?
- A. Arterial blood gases
- B. Liver function tests
- C. Troponin levels
- D. Blood glucose levels
Correct Answer: B
Rationale: The correct answer is B: Liver function tests. Valproic acid is known to potentially cause hepatotoxicity, so it is essential to assess baseline liver function tests before administering the medication. Monitoring liver function tests can help identify any pre-existing liver conditions and prevent further liver damage. Arterial blood gases (A) are not directly related to valproic acid administration. Troponin levels (C) are used to assess heart muscle damage, which is not a concern with valproic acid. Blood glucose levels (D) are not specifically relevant to valproic acid therapy.
A nurse in a provider's office is collecting data from a client who continues to have a migraine headache after taking sumatriptan orally 2 hr ago. Which of the following findings is the priority for the nurse to report?
- A. Tingling sensation
- B. Hypertension
- C. Flushing
- D. Dizziness
Correct Answer: B
Rationale: The correct answer is B: Hypertension. The priority for the nurse to report is hypertension because sumatriptan can potentially cause an increase in blood pressure as a side effect. Hypertension is a serious condition that can lead to complications if not managed promptly.
A: Tingling sensation is a common side effect of sumatriptan and may not be immediately concerning.
C: Flushing is also a common side effect of sumatriptan and is usually not a priority.
D: Dizziness is a less severe side effect compared to hypertension and can often be managed with rest.
A nurse is collecting data from a client who is experiencing oxycodone toxicity. Which of the following findings should the nurse expect?
- A. Tachypnea
- B. Sedation
- C. Dilated pupils
- D. Tachycardia
Correct Answer: B
Rationale: The correct answer is B: Sedation. Oxycodone is an opioid that depresses the central nervous system, leading to sedation as a common manifestation of toxicity. Tachypnea (A) is more commonly associated with opioid withdrawal rather than toxicity. Dilated pupils (C) are more indicative of stimulant toxicity, not opioids. Tachycardia (D) is unlikely with oxycodone toxicity due to its depressant effects on the cardiovascular system. Other choices are not relevant to oxycodone toxicity.
A nurse is reviewing the medical record of a client who is to start using a scopolamine patch for postoperative nausea and vomiting. Which of the following findings is a contraindication for the client to receive the medication?
- A. Ménière's disease
- B. Increased lacrimation
- C. Narrow-angle glaucoma
- D. Urinary frequency
Correct Answer: C
Rationale: The correct answer is C: Narrow-angle glaucoma. Scopolamine can cause pupillary dilation, leading to an increase in intraocular pressure, which can worsen narrow-angle glaucoma. This can potentially result in a sudden increase in pressure within the eye, leading to severe pain, vision changes, and even blindness. Therefore, it is crucial to avoid giving scopolamine to clients with narrow-angle glaucoma to prevent these serious complications.
Choice A: Ménière's disease is not a contraindication for scopolamine patch use.
Choice B: Increased lacrimation is not a contraindication for scopolamine patch use.
Choice D: Urinary frequency is not a contraindication for scopolamine patch use.
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. Hyperkalemia
- B. Hypoglycemia
- C. Hypokalemia
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to elevated potassium levels (hyperkalemia). Lisinopril is an ACE inhibitor that may also contribute to increased potassium levels. Monitoring for hyperkalemia is essential due to the risk of serious cardiac arrhythmias. Hypoglycemia (choice B) and hyperglycemia (choice D) are not typically associated with these medications. Hypokalemia (choice C) is the opposite of what is expected with spironolactone.