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A patient has just received an injection of onabotulinumtoxin A. The nurse will monitor for which adverse effects? (Select all that apply.)
- A. Insomnia
- B. Dysphagia
- C. Weight gain
- D. GI upset
- E. Difficulty breathing
Correct Answer: B,E
Rationale: Onabotulinumtoxin A (Botox) carries a Black Box Warning for toxin spread beyond the injection site, which may cause dysphagia and breathing difficulties. Insomnia, weight gain, and GI upset are not commonly associated adverse effects.
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A 22-year-old nursing student has been taking caffeine tablets for the past few weeks to 'make it through' the end of the semester and exam week. She is in the university clinic today because she is 'exhausted.' What human needs statement may be appropriate for her?
- A. Altered oxygenation need
- B. Altered physical activity
- C. Altered need for sleep
- D. Altered food intake
Correct Answer: C
Rationale: Caffeine, a CNS stimulant, can cause restlessness, anxiety, and insomnia, leading to an altered need for sleep. This is the most relevant human needs statement given her exhaustion from overuse. The other options are not directly related to caffeine's effects.
A 10-year-old patient will be started on methylphenidate hydrochloride therapy. The nurse will perform which essential baseline assessment before this drug is started?
- A. Eye examination
- B. Height and weight
- C. Liver function studies
- D. Hearing test
Correct Answer: B
Rationale: Methylphenidate may cause temporary growth suppression in children, making baseline height and weight assessment essential for monitoring. Eye exams, liver function studies, and hearing tests are not routinely required for this therapy.
A patient who started taking orlistat 1 month ago calls the clinic to report some 'embarrassing' adverse effects. She tells the nurse that she has had episodes of 'not being able to control my bowel movements.' Which statement is true about this situation?
- A. These are expected adverse effects that will eventually diminish.
- B. The patient will need to stop this drug immediately if these adverse effects are occurring.
- C. The patient will need to increase her fat intake to prevent these adverse effects.
- D. The patient will need to restrict fat intake to less than 30% of total calories to help reduce these adverse effects.
Correct Answer: D
Rationale: Orlistat's gastrointestinal side effects, such as fecal incontinence, are related to its mechanism of inhibiting fat absorption. Restricting dietary fat to less than 30% of total calories can reduce these effects. They are not expected to diminish entirely without dietary changes, stopping the drug is not necessary, and increasing fat intake would worsen the effects.
The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.)
- A. Narcolepsy
- B. Depression
- C. Panic attacks
- D. Neonatal apnea
- E. Attention deficit hyperactivity disorder (ADHD)
- F. Appetite suppression
- G. Migraine headaches
Correct Answer: A,D,E,F,G
Rationale: CNS stimulants are indicated for narcolepsy, neonatal apnea, ADHD, appetite suppression in obesity treatment, and migraine headaches (via triptans). They are not used for depression or panic attacks, as they may worsen these conditions.
When evaluating a patient who is taking orlistat, which is an intended therapeutic effect?
- A. Increased wakefulness
- B. Increased appetite
- C. Decreased weight
- D. Decreased hyperactivity
Correct Answer: C
Rationale: Orlistat is a nonstimulant drug used for weight loss by inhibiting fat absorption, making decreased weight the intended therapeutic effect. It does not affect wakefulness, appetite, or hyperactivity.