Nokea
A practical nurse (PN) is providing education to a client who is starting therapy with metformin for type 2 diabetes. What side effect should the client be instructed to report to the healthcare provider?
- A. Weight gain
- B. Hypoglycemia
- C. Muscle pain
- D. Nausea
Correct Answer: D
Rationale: The correct answer is 'Nausea.' Nausea is a common side effect of metformin, especially when the medication is first started. It is essential for the client to report persistent or severe nausea to the healthcare provider for further evaluation and management. Weight gain (Choice A) is not a typical side effect of metformin; in fact, metformin is associated with weight loss or weight neutrality. Hypoglycemia (Choice B) is a potential side effect of some diabetes medications, but metformin does not typically cause hypoglycemia. Muscle pain (Choice C) is not a common side effect of metformin; it is more commonly associated with other medications like statins.
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A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?
- A. Avoid hazardous activities until symptoms subside
- B. Contact the healthcare provider immediately
- C. Continue taking the medication every day
- D. Stop taking the medication until the unpleasant side effects wear off
Correct Answer: A
Rationale: The correct instruction for the nurse to provide is to advise the client to avoid hazardous activities until the symptoms of fatigue and dizziness subside. These side effects can impair the client's ability to engage in activities that require alertness and coordination, posing a risk for accidents. Contacting the healthcare provider immediately may not be necessary unless the symptoms worsen or persist. Continuing to take the medication every day without addressing the side effects can lead to further complications. Stopping the medication abruptly without healthcare provider guidance can also be risky and may not be necessary if the symptoms improve with time.
A client with chronic pain is prescribed oxycodone. What instruction should the practical nurse (PN) include in the client's teaching plan?
- A. Take the medication with meals to avoid gastrointestinal upset.
- B. Avoid taking the medication with alcohol.
- C. Increase fluid intake to avoid constipation.
- D. Report any signs of respiratory depression to the healthcare provider.
Correct Answer: B
Rationale: The correct answer is to instruct the client to avoid taking oxycodone with alcohol. Mixing oxycodone with alcohol can lead to serious side effects, including respiratory depression. Taking the medication with meals may not always be necessary, and instructions about fluid intake to avoid constipation are important but not the priority when considering the immediate risks associated with oxycodone. While reporting signs of respiratory depression is crucial, preventing it by avoiding alcohol is key in the client's safety.
A home health care nurse observes that a client with Parkinson's syndrome is experiencing increased tremors and difficulty in movement. What should the nurse do in response to this finding?
- A. Report the observed finding to the healthcare provider right away
- B. Arrange a medical evaluation so the medication dose can be adjusted
- C. Schedule a return home visit in 2 weeks to monitor
- D. Explain that this is an expected progression of Parkinson's
Correct Answer: B
Rationale: In a client with Parkinson's syndrome experiencing increased tremors and movement difficulty, arranging a medical evaluation is crucial to adjust the medication dose. This proactive approach helps in managing the symptoms effectively. Reporting the finding to the healthcare provider may delay necessary adjustments in treatment. Scheduling a return home visit in 2 weeks may not address the immediate need for medication adjustment. Explaining that the progression is expected without taking action does not address the client's worsening symptoms.
Which assessment finding indicates that the expected outcome of administering donepezil to a client with Alzheimer's disease has been accomplished?
- A. Increased muscle strength and tone
- B. Fewer episodes of urinary incontinence
- C. Decreased confusion and improved mood
- D. Reversal of the disease process as evidenced by increased functioning
Correct Answer: C
Rationale: The correct answer is C. Donepezil is a medication used for individuals with Alzheimer's disease. Its mechanism of action involves increasing acetylcholine levels by inhibiting its breakdown, which benefits cognitive function. The expected outcome of administering donepezil is a decrease in confusion and an improvement in mood due to the medication's impact on neurotransmitters. Choices A, B, and D are incorrect because donepezil does not primarily target muscle strength, urinary incontinence, or disease reversal; instead, it aims to slow down the progression of cognitive decline in Alzheimer's disease.
A client is prescribed verapamil for hypertension. The nurse should monitor the client for which common adverse effect?
- A. Constipation
- B. Headache
- C. Muscle cramping
- D. Fatigue
Correct Answer: A
Rationale: Verapamil, a calcium channel blocker commonly used for hypertension, is known to cause constipation as a frequent adverse effect. This occurs due to its effects on smooth muscle relaxation in the gastrointestinal tract, leading to decreased motility. Headache, muscle cramping, and fatigue are not typically associated with verapamil use and are less common side effects. Therefore, the nurse should closely monitor the client for symptoms of constipation when administering verapamil.