Nokea
High uric acid levels can develop in clients who are receiving chemotherapy. This can be caused by:
- A. the inability of the kidneys to excrete the drug metabolites
- B. rapid cell catabolism
- C. toxic effects of the prophylactic antibiotics that are given concurrently
- D. the altered blood pH from the acid medium of the drugs
Correct Answer: B
Rationale: Chemotherapy causes rapid cell destruction, releasing uric acid as a metabolite, which can elevate levels and risk conditions like gout or kidney stones.
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The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?
- A. I take my Lipitor with a glass of milk after my breakfast.
- B. I take my Lipitor and wait 30 minutes before taking my other medications.
- C. I take my Lipitor 30 minutes after I eat something.
- D. I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.
Correct Answer: D
Rationale: Grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to breakdown the drug, which leads to excessive amounts of the drug in the body.
The client is placed on lorazepam for short-term treatment of anxiety. Which instruction by the nurse is most important with lorazepam use?
- A. Take a second tablet if your anxiety is not being adequately relieved.
- B. If lorazepam is less effective after a few weeks, notify your provider.
- C. Avoid caffeinated foods and beverages, including tea and chocolate.
- D. If you are experiencing drowsiness or dizziness, notify your provider.
Correct Answer: B
Rationale: Lorazepam (Ativan) is a benzodiazepine anxiolytic and sedative-hypnotic medication. If it is less effective after a few weeks, the client may be developing a tolerance to lorazepam, and the HCP should be notified of this.
The client, admitted to the ED, is prescribed to receive 0.5 mg epinephrine subcutaneously for treatment of a severe asthma attack. The medication for injection is supplied in a vial that contains 5 mg/mL. How many milliliters of epinephrine should the nurse administer?
Correct Answer: 0.1
Rationale: Use a proportion to determine the amount in milliliters; then multiply the extremes (outside values) and the means (inside values) and solve for X. 5 mg: 1 mL :: 0.5 mg: X mL; 5X = 0.5 mL; X = 0.1 mL; the nurse should administer 0.1 mL of epinephrine (Adrenalin).
The nurse is assessing the client. Which findings indicate that the client may be experiencing physical changes from long-term use of prednisone? Select all that apply.
- A. Weight gain
- B. Increased muscle mass
- C. Fragile skin
- D. Acne vulgaris
- E. Alopecia
Correct Answer: A,C,D
Rationale: A: Weight gain and muscle atrophy are body changes that may occur with long-term glucocorticoid therapy. B: Muscle wasting (not increased muscle mass) is a side effect of prednisone. C: Fragile skin is a possible body change that may occur with long-term glucocorticoid therapy. D: Acne vulgaris may occur with long-term glucocorticoid therapy. E: Hirsutism (not alopecia) is a side effect of prednisone.
The client is started on citalopram for treatment of depression. Which information is most important for the nurse to include when teaching the client?
- A. Activity levels should be increased to include a daily exercise routine.
- B. If sexual side effects become unbearable, consult your health care provider.
- C. Taking St. John's wort with your citalopram can enhance its effectiveness.
- D. Take your blood pressure every morning and report Ascertain any significant changes.
Correct Answer: B
Rationale: Sexual dysfunction is a common side effect associated with the use of SSRIs; the client taking citalopram (Celexa), an SSRI, should consult the HCP if having unbearable sexual side effects.