Nokea
A patient with bipolar disorder is prescribed valproic acid. What is an important side effect for the nurse to monitor?
- A. Hypertension
- B. Liver toxicity
- C. Hyperglycemia
- D. Bradycardia
Correct Answer: B
Rationale: Correct Answer: B (Liver toxicity)
Rationale:
1. Valproic acid is known to cause liver toxicity.
2. The nurse should monitor liver function tests regularly.
3. Signs of liver toxicity include jaundice, abdominal pain, and nausea.
4. Prompt detection is crucial to prevent serious complications.
Summary:
A: Hypertension - Not a common side effect of valproic acid.
C: Hyperglycemia - More commonly associated with other medications like antipsychotics.
D: Bradycardia - Not a typical side effect of valproic acid.
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A client is on a mechanical ventilator. Which client response indicates that the neuromuscular blocker tubocurarine chloride (Tubarine) is effective?
- A. The client's extremities are paralyzed.
- B. The peripheral nerve stimulator causes twitching.
- C. The client clenches fist upon command.
- D. The client's Glasgow Coma Scale score is 14.
Correct Answer: A
Rationale: The correct answer is A because the neuromuscular blocker tubocurarine chloride causes muscle paralysis, leading to the extremities being paralyzed. This indicates that the medication is effectively blocking neuromuscular transmission.
B: Twitching with peripheral nerve stimulation indicates incomplete blockade.
C: Clenching fist upon command indicates preserved muscle strength.
D: Glasgow Coma Scale measures level of consciousness, not neuromuscular blockade.
A patient with chronic kidney disease (CKD) is prescribed erythropoietin. What is the primary action of this medication?
- A. Stimulate white blood cell production
- B. Increase platelet count
- C. Promote red blood cell production
- D. Enhance clotting factor production
Correct Answer: C
Rationale: The correct answer is C: Promote red blood cell production. Erythropoietin is a hormone that stimulates the production of red blood cells in the bone marrow. This is crucial for patients with CKD who often develop anemia due to decreased erythropoietin production.
A: Stimulating white blood cell production is the function of other medications, such as colony-stimulating factors, not erythropoietin.
B: Erythropoietin does not have an effect on platelet count.
D: Enhancing clotting factor production is not the primary action of erythropoietin.
What instruction should the nurse give regarding the administration of alendronate to a patient with osteoporosis?
- A. Take the medication with milk.
- B. Lie down for 30 minutes after taking the medication.
- C. Take the medication with a full glass of water.
- D. Take the medication before bedtime.
Correct Answer: C
Rationale: The correct answer is C: Take the medication with a full glass of water. Alendronate should be taken with a full glass of water on an empty stomach in the morning to enhance absorption. Option A is incorrect because taking alendronate with milk decreases its absorption. Option B is incorrect as lying down after taking alendronate can lead to esophageal irritation. Option D is incorrect because taking the medication before bedtime can cause esophageal irritation as well due to the risk of reflux when lying down.
A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: C
Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.
A patient with chronic heart failure is prescribed furosemide. What is the primary action of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: B
Rationale: The correct answer is B: Reduce fluid retention. Furosemide is a loop diuretic that works by increasing urine production, leading to the removal of excess fluid and sodium from the body. This helps reduce fluid volume overload in conditions like heart failure. Choice A is incorrect because while reducing fluid retention may indirectly improve cardiac output by reducing preload, furosemide itself does not directly increase cardiac output. Choice C is incorrect as furosemide does not have a direct effect on heart rate. Choice D is incorrect because while furosemide may lower blood pressure as a result of reducing fluid volume, its primary action is to reduce fluid retention, not specifically lower blood pressure.