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Drugs can cause adverse events in a patient. Bone marrow toxicity is one of the most frequent types of drug-induced toxicity. The most serious form of bone marrow toxicity is:
- A. Aplastic anemia.
- B. Thrombocytosis.
- C. Leukocytosis.
- D. Granulocytosis.
Correct Answer: A
Rationale: Aplastic anemia is the most severe form of bone marrow toxicity, characterized by pancytopenia and bone marrow failure. It can be life-threatening and requires immediate intervention. Thrombocytosis, leukocytosis, and granulocytosis are not typically associated with drug-induced bone marrow toxicity.
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A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?
- A. Irregular heart rhythm
- B. Abnormal uterine bleeding
- C. Yellowing of the sclera or dark-colored urine
- D. Difficulty swallowing
Correct Answer: B
Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.
A client has a new prescription for Atenolol. Which of the following instructions should the nurse provide?
- A. Take this medication with grapefruit juice.
- B. Monitor your blood pressure and heart rate regularly.
- C. You may experience a rapid heart rate.
- D. Increase your intake of potassium-rich foods.
Correct Answer: B
Rationale: The correct answer is B: 'Monitor your blood pressure and heart rate regularly.' Atenolol is a beta-blocker used to treat hypertension and other cardiovascular conditions. Patients should monitor their blood pressure and heart rate regularly to assess the medication's effectiveness and check for adverse effects like bradycardia or hypotension. Choice A is incorrect because Atenolol should not be taken with grapefruit juice, which can interfere with its absorption. Choice C is incorrect because Atenolol typically causes a decrease in heart rate, not a rapid heart rate. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Atenolol.
A healthcare professional is about to administer Propranolol to a patient. The healthcare professional takes the patient's apical pulse and documents it as 58 bpm. How should the healthcare professional proceed?
- A. Administer the medication as prescribed
- B. Administer half of the normal dose
- C. Consider the extended-release form of the medication
- D. Withhold administration of the medication and notify the healthcare provider
Correct Answer: D
Rationale: When a patient's apical pulse is 58 bpm, it is below the normal range. Propranolol is a beta-blocker that can further lower the heart rate. Therefore, it is crucial to withhold the medication and notify the healthcare provider to evaluate the patient's condition. Administering Propranolol in this situation can exacerbate bradycardia, leading to serious complications. Choosing to administer the medication as prescribed (Choice A) can put the patient at risk. Administering half of the normal dose (Choice B) without healthcare provider guidance is not appropriate in this case. Considering the extended-release form of the medication (Choice C) does not address the immediate concern of bradycardia and is not the best course of action.
What should you monitor when administering Clopidogrel to a patient?
- A. Signs of thrombotic thrombocytopenic purpura
- B. Bleeding during therapy
- C. CBC with differential and platelet count
- D. All of the above
Correct Answer: D
Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.
A patient was admitted to the emergency department with a pulse oximeter reading of 85% after a successful prehospital resuscitation from cardiac arrest due to an asthma attack. What is the most important initial drug to administer as ordered?
- A. Epinephrine
- B. Sodium bicarbonate
- C. Albuterol
- D. Oxygen
Correct Answer: D
Rationale: Oxygen is the most important initial intervention for a patient with a low pulse oximeter reading (85%) to correct hypoxia and prevent further complications. While epinephrine (A) and albuterol (C) are used to treat asthma, oxygen is the priority to address the immediate hypoxia. Sodium bicarbonate (B) is not indicated unless there is severe metabolic acidosis.