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After administering five doses of filgrastim, the nurse observes that the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3. What action should the nurse take?
- A. Inform the patient that the medication has been effective.
- B. Review the patient’s culture and sensitivity reports.
- C. Implement neutropenic precautions.
- D. Assess the patient’s vital signs.
Correct Answer: A
Rationale: Filgrastim stimulates white blood cell production. An increase from 2,500/mm^3 to 5,000/mm^3 (A) indicates effectiveness, and the patient should be informed. Culture reports (B) are unrelated to filgrastim’s action. Neutropenic precautions (C) are unnecessary with improved counts. Vital signs (D) don’t directly assess filgrastim’s efficacy.
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A client with benign prostatic hyperplasia has been prescribed tamsulosin. What should the nurse do to monitor for an adverse reaction?
- A. Monitor the client’s blood pressure.
- B. Assess the client’s urine output.
- C. Perform a bladder scan.
- D. Obtain the client’s daily weights.
Correct Answer: A
Rationale: This question is identical to Question 29. Tamsulosin can cause hypotension (A), necessitating blood pressure monitoring. Urine output (B), bladder scans (C), and weights (D) don’t address adverse effects. Note: Duplicate question; consider removing.
The nurse is preparing a discharge teaching plan for a patient who is taking ciprofloxacin hydrochloride tablets due to suspected anthrax exposure. What instructions should be included in the teaching plan?
- A. Crush and mix the tablets with pudding if you have trouble swallowing the tablets.
- B. Increase fluid intake while taking the medication.
- C. Use nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve mild joint aches and pains caused by the medication.
- D. Report any tendon pain or swelling to the healthcare provider immediately.
- E. Limit exposure to sunlight and avoid tanning beds.
Correct Answer: B,D,E
Rationale: Ciprofloxacin requires high fluid intake (B) to prevent crystalluria, immediate reporting of tendon pain/swelling (D) due to rupture risk, and sun protection (E) due to photosensitivity. Crushing tablets (A) alters release, risking side effects. NSAIDs (C) increase seizure risk with ciprofloxacin.
While evaluating a patient who has been taking acetaminophen for chronic pain, the nurse notices that the patient’s skin appears yellow. What action should the nurse take in response to this observation?
- A. Suggest the patient to reduce the dosage of the medication.
- B. Check the patient’s capillary glucose level.
- C. Use a pulse oximeter to assess the patient’s oxygen saturation.
- D. Report the observation to the healthcare provider.
Correct Answer: D
Rationale: Yellow skin (jaundice) suggests liver damage, a serious acetaminophen side effect. Reporting to the provider (D) is critical for evaluation. Reducing dosage (A) without consultation is unsafe. Glucose (B) and oxygen saturation (C) are unrelated to jaundice.
The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion?
- A. Hypertension.
- B. Scratchy throat.
- C. Bradycardia.
- D. Pupillary constriction.
Correct Answer: B
Rationale: A scratchy throat (B) may indicate an allergic reaction, potentially anaphylaxis, requiring immediate cessation of the piperacillin-tazobactam infusion and assessment. Hypertension (A), bradycardia (C), and pupillary constriction (D) are not typical signs of an allergic response to this antibiotic.
A patient with chemotherapy-induced nausea has been prescribed metoclopramide. What adverse effect should the nurse report?
- A. Diarrhea.
- B. Unusual irritability.
- C. Nausea.
- D. Involuntary movements.
Correct Answer: D
Rationale: This question is identical to Question 5. Involuntary movements (D), such as tardive dyskinesia, are a serious metoclopramide side effect, requiring immediate reporting. Diarrhea (A) and irritability (B) are less severe. Nausea (C) is the treated condition. Note: Duplicate question; consider removing.