Nokea
During an admission assessment, a client informs the nurse that they take propylthiouracil (PTU) daily. Based on this information, the nurse suspects that the client has a history of:
- A. Myxedema
- B. Graves' disease
- C. Addison's disease
- D. Cushing's syndrome
Correct Answer: B
Rationale: Propylthiouracil (PTU) is a medication commonly used to treat hyperthyroidism, including Graves' disease, which is characterized by an overactive thyroid gland. The client mentioning the daily use of PTU indicates that they likely have a history of Graves' disease, as this medication helps manage the condition by reducing the production of thyroid hormones. Therefore, the correct answer is B: Graves' disease.
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A client is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. The nurse notes redness and swelling at the site, along with a slowed infusion rate. What is the appropriate action for the nurse to take?
- A. Notify the healthcare provider.
- B. Administer pain medication to reduce discomfort.
- C. Apply ice and maintain the infusion rate as prescribed.
- D. Elevate the extremity of the IV site and slow the infusion rate.
Correct Answer: A
Rationale: When a client complains of pain at the IV insertion site, and there are signs of extravasation such as redness and swelling, it is crucial to notify the healthcare provider immediately. Extravasation of antineoplastic medications can cause tissue damage, pain, and necrosis if they escape into surrounding tissues. Prompt action is necessary to prevent further complications and ensure appropriate management of the situation.
A client is receiving morphine sulfate for pain management. Which assessment finding requires immediate action?
- A. Constipation
- B. Drowsiness
- C. Respiratory rate of 10 breaths per minute
- D. Nausea
Correct Answer: C
Rationale: A respiratory rate of 10 breaths per minute indicates respiratory depression, a serious side effect of morphine sulfate that can lead to respiratory compromise and requires immediate intervention. Constipation, drowsiness, and nausea are common side effects of morphine but are not immediately life-threatening compared to respiratory depression.
A nurse preparing a client for surgery reviews the client's medication record. The client is to be nothing per mouth (NPO) after midnight. Which of the following medications, if noted on the client's record, should the nurse question?
- A. Cyclobenzaprine (Flexeril)
- B. Alendronate (Fosamax)
- C. Allopurinol (Zyloprim)
- D. Prednisone
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- A. Glucose level
- B. Calcium level
- C. Potassium level
- D. Prothrombin time
Correct Answer: B
Rationale: The correct answer is B: Calcium level. Tamoxifen may increase calcium levels, leading to hypercalcemia. Symptoms of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, muscle weakness, and bone pain. Monitoring serum calcium levels is essential to detect and manage this potential side effect.
Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?
- A. Gastric atony
- B. Urinary strictures
- C. Neurogenic atony
- D. Gastroesophageal reflux
Correct Answer: B
Rationale: Bethanechol chloride (Urecholine) should not be administered to clients with urinary strictures as it can contract the bladder and increase pressure within the urinary tract. In individuals with urinary strictures, this elevated pressure may lead to bladder rupture. Therefore, caution is advised when considering the use of Bethanechol chloride in clients with urinary strictures to prevent potential complications.