Nokea
For a client with an exacerbation of rheumatoid arthritis, the physician prescribes the corticosteroid prednisone (Deltasone). When caring for this client, the nurse should monitor for which adverse drug reactions?
- A. Increased weight, hypertension, and insomnia
- B. Vaginal bleeding, jaundice, and inflammation
- C. Stupor, breast lumps, and pain
- D. Dyspnea, numbness, and headache
Correct Answer: A
Rationale: The correct answer is A. Prednisone is a corticosteroid that can cause adverse reactions such as increased weight due to fluid retention, hypertension due to sodium retention, and insomnia due to its stimulating effects. Vaginal bleeding, jaundice, inflammation, stupor, breast lumps, pain, dyspnea, numbness, and headache are not commonly associated with prednisone use. Monitoring for weight changes, blood pressure, and sleep patterns is essential when administering prednisone to a client with rheumatoid arthritis for early detection and management of adverse reactions.
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A client with cancer that has metastazised to the liver is started on chemotherapy- His physician has specified divided doses of the antimetabolite. The client asks why he could take the drug in divided doses. The appropriate response is:
- A. " There really is no reason your doctor just wrote the orders that way."
- B. "This schedule will reduce the side effect of the drug."
- C. "Divided doses produce greater cytotoxic effects on the diseased cells."
- D. "Because these drugs prevent cell division, they are more effective in divided doses,"
Correct Answer: C
Rationale: The correct answer is C: "Divided doses produce greater cytotoxic effects on the diseased cells." Dividing the doses of the antimetabolite allows for more consistent levels of the drug in the bloodstream, ensuring sustained exposure to the cancer cells. This continuous exposure enhances the drug's cytotoxic effects, increasing its efficacy in targeting and destroying the diseased cells. Options A and B provide vague or incorrect information, while option D is misleading as antimetabolites do not prevent cell division, but rather disrupt DNA synthesis.
The nurse observes the temperature record of a client and relates the fever to the brain infection the client currently has. The nurse knows that a high temperature may lead to an increased cerebral irritation. Which of the ff measures can help the nurse control the clients body temperature? Choose all that apply
- A. Providing tepid sponge bath
- B. Applying ice packs
- C. Administering prescribed antipyretics
- D. Keeping the room temperature warm
Correct Answer: A
Rationale: The correct answer is A: Providing tepid sponge bath. This measure helps lower body temperature through evaporation of water from the skin. It is effective in managing fever without causing shivering or discomfort. Ice packs (B) can lead to vasoconstriction and shivering, raising body temperature. Antipyretics (C) are drugs that can reduce fever but may not address the underlying cause. Keeping the room warm (D) can exacerbate fever by hindering heat dissipation.
What deficits would the nurse expect in a right-handed person experiencing a stroke affecting the left side of the cortex?
- A. Expressive aphasia and paralysis on the right side of the body.
- B. Expressive aphasia and paralysis on the left side of the body. .
- C. Dysarthria and paralysis on the right side of the body.
- D. Mixed aphasia and paralysis on the right side of the body.
Correct Answer: B
Rationale: The correct answer is B: Expressive aphasia and paralysis on the left side of the body. In a right-handed person, the left side of the brain controls language (Broca's area) and motor function for the right side of the body. A stroke affecting the left side of the cortex would lead to expressive aphasia (difficulty speaking) due to damage to Broca's area and paralysis on the right side of the body due to motor function impairment. Choices A, C, and D are incorrect because they do not align with the known neurological functions of the brain regions affected by the stroke.
Hyperparathyroidism is caused by increased levels of thyroxine in blood plasma. A client with this endocrine dysfunction would experience:
- A. Heat intolerance and systolic
- B. Diastolic hypertension and widened hypertension pulse pressure
- C. Weight gain and heat intolerance
- D. Anorexia and hyper-excitability
Correct Answer: A
Rationale: The correct answer is A because hyperparathyroidism is not caused by increased levels of thyroxine but by overactivity of the parathyroid glands. This would lead to symptoms of heat intolerance due to increased metabolism and systolic hypertension due to the effects of excess parathyroid hormone on calcium levels.
Choice B is incorrect because diastolic hypertension and widened pulse pressure are not typical symptoms of hyperparathyroidism. Choice C is incorrect because weight gain is not a common symptom of hyperparathyroidism. Choice D is incorrect because anorexia and hyper-excitability are not typical symptoms of hyperparathyroidism.
What is an important consideration regarding TPN administration?
- A. IV site is kept aseptic while infusing the solution
- B. Feeding is poured into a pouch and then infused
- C. Solution is only hung for a maximum of 8 hours at a time
- D. New formula is added as needed so the line does not run dry
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Aseptic technique prevents infection at IV site.
2. TPN is a high-risk solution, requiring strict aseptic administration.
3. Contaminated site can lead to sepsis or other serious complications.
4. Choice B increases risk of contamination.
5. Choice C increases risk of bacterial growth.
6. Choice D may introduce air or contamination.
Summary:
Choice A is correct as it emphasizes infection prevention. Choices B, C, and D pose risks of contamination, bacterial growth, or air introduction.