Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder?
- A. Myxedema
- B. Renal failure
- C. Hypothyroidism
- D. Diabetes mellitus
Correct Answer: B
Rationale: Colchicine is contraindicated in clients with severe gastrointestinal, renal, hepatic, or cardiac disorders, or blood dyscrasias. Renal failure is a condition where the kidneys fail to function adequately, leading to the accumulation of toxins in the body. Since colchicine is contraindicated in clients with renal disorders, including renal failure, it could exacerbate the condition and worsen the client's health.
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A client is receiving intravenous gentamicin (Garamycin). Which of the following findings should prompt the nurse to notify the healthcare provider immediately?
- A. Nausea
- B. Hearing loss
- C. Headache
- D. Diarrhea
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?
- A. Tremors
- B. Dizziness
- C. Confusion
- D. Hallucinations
Correct Answer: C
Rationale: Older clients are particularly vulnerable to central nervous system side effects of cimetidine. The most frequent side effect is confusion. It is crucial for nurses to be vigilant in monitoring for confusion as it can impact the client's safety and well-being. While tremors, dizziness, and hallucinations are possible side effects, confusion is the most common in older clients taking cimetidine.
When reviewing laboratory results for a client receiving tacrolimus (Prograf), which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?
- A. Blood glucose of 200 mg/dL
- B. Potassium level of 3.8 mEq/L
- C. Platelet count of 300,000 cells/mm³
- D. White blood cell count of 6000 cells/mm³
Correct Answer: A
Rationale: An elevated blood glucose level of 200 mg/dL indicates an adverse effect of tacrolimus. This finding suggests hyperglycemia, which is a known adverse effect of the medication. Other potential adverse effects of tacrolimus include neurotoxicity and hypertension. Monitoring blood glucose levels is crucial to detect and manage this adverse effect promptly.
The clinic nurse is reviewing a teaching plan for a client receiving antineoplastic medication. When implementing the plan, the nurse should advise the client:
- A. To take aspirin (acetylsalicylic acid) as needed for a headache
- B. To avoid drinking beverages containing alcohol
- C. To consult with healthcare providers (HCPs) before receiving immunizations
- D. That it is necessary to consult HCPs before receiving a flu vaccine at the local health fair
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Heparin sodium is prescribed for the client. The nurse expects that the healthcare provider will prescribe which of the following to monitor for a therapeutic effect of the medication?
- A. Hematocrit level
- B. Hemoglobin level
- C. Prothrombin time (PT)
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: D
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the therapeutic effect of heparin sodium. Heparin affects the intrinsic pathway of coagulation, and monitoring aPTT helps ensure the medication is within the therapeutic range to prevent clot formation. Hematocrit and hemoglobin levels assess red blood cell concentrations, while prothrombin time (PT) is used to monitor the therapeutic effect of warfarin sodium, a different anticoagulant that affects the extrinsic pathway of coagulation.
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