Nokea
Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?
- A. Pallor
- B. Drowsiness
- C. Bradycardia
- D. Restlessness
Correct Answer: D
Rationale: Signs of toxicity related to oxybutynin chloride (Ditropan XL) include central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity may include hypotension or hypertension, confusion, tachycardia, a flushed or red face, and signs of respiratory depression. Restlessness is a sign of central nervous system excitation, which can indicate a possible toxic effect of this medication.
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A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which statement by the client indicates a need for further teaching?
- A. I will avoid foods high in vitamin K.
- B. I will take the medication at the same time each day.
- C. I will use an electric razor to shave.
- D. I will take aspirin if I have a headache.
Correct Answer: D
Rationale: Clients taking warfarin (Coumadin) should avoid aspirin unless prescribed by their healthcare provider, as it can increase the risk of bleeding. The other statements are correct and do not indicate a need for further teaching. Taking aspirin along with warfarin can potentiate the anticoagulant effects of warfarin, leading to an increased risk of bleeding complications.
Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client:
- A. Cut the dose in half.
- B. Discontinue the medication.
- C. Take the medication with food.
- D. Contact the healthcare provider (HCP).
Correct Answer: C
Rationale: Isosorbide mononitrate can cause headaches, which usually disappear during continued therapy. Taking the medication with food or meals can help alleviate the headache. It is important to recommend this approach before considering dose adjustments or discontinuation of the medication. Contacting the healthcare provider would be necessary if the headache persists despite taking the medication with food.
A client presenting with complaints of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension, including a beta-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
- A. Dyspnea, edema, and palpitations
- B. Chest pain, hypotension, and paresthesia
- C. Double vision, loss of appetite, and nausea
- D. Constipation, dry mouth, and sleep disorder
Correct Answer: C
Rationale: The correct answer is C. Double vision, loss of appetite, and nausea are classic signs of digoxin toxicity. Other signs may include bradycardia, visual disturbances, and confusion. These symptoms are indicators that the client may be experiencing adverse effects due to elevated levels of digoxin in the system, requiring immediate medical attention to prevent serious complications.
A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.
A client is being educated about the use of sertraline (Zoloft) for depression. Which statement by the client indicates a need for further teaching?
- A. I should take the medication with a high-protein meal.
- B. I may experience dizziness when getting up quickly.
- C. I might notice a decrease in my sex drive.
- D. I should report any thoughts of self-harm to my healthcare provider.
Correct Answer: A
Rationale: The statement 'I should take the medication with a high-protein meal' indicates a need for further teaching as sertraline (Zoloft) should not be taken with a high-protein meal due to potential interference with medication absorption. Choices B, C, and D are correct statements associated with the use of sertraline for depression. It is common to experience dizziness when quickly getting up, notice a decrease in sex drive, and important to report any thoughts of self-harm to the healthcare provider while on this medication.