Nokea
Phenobarbital (luminal) is given to a client for a short treatment of anxiety. Which of the following results would indicate a therapeutic serum range of the medication?
- A. 5-10 mcg/ml
- B. 15-40 mcg/ml
- C. 45-65 mcg/ml
- D. 50-90 mcg/ml
Correct Answer: A
Rationale: The therapeutic serum range for phenobarbital (luminal) in the treatment of anxiety is typically 5-10 mcg/ml. This range is considered effective in managing anxiety symptoms while minimizing the risk of side effects associated with higher levels of the medication. Lower serum levels may be ineffective in treating anxiety, while higher levels increase the risk of adverse effects. Therefore, maintaining the serum concentration within the range of 5-10 mcg/ml is optimal for therapeutic benefits with minimal risks.
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A client has a new prescription for Sucralfate. Which of the following instructions should the nurse include?
- A. Take the medication on an empty stomach.
- B. Increase your intake of high-sodium foods.
- C. Take the medication with a full glass of milk.
- D. Expect your stools to be black and tarry.
Correct Answer: A
Rationale: The correct instruction that the nurse should include for a client prescribed Sucralfate is to take the medication on an empty stomach. Sucralfate works by forming a protective barrier over ulcers, which is most effective when the stomach is empty. Taking it with food or other medications may decrease its effectiveness. Instructing the client to take Sucralfate on an empty stomach helps ensure optimal therapeutic benefits. Choices B, C, and D are incorrect because increasing high-sodium foods is not related to Sucralfate therapy, taking the medication with a full glass of milk is not recommended as it may decrease its effectiveness, and the presence of black and tarry stools is not an expected outcome of Sucralfate.
What nursing interventions should you perform when a patient is on Albuterol? (Select all that apply)
- A. Assess lung sounds, pulse, and blood pressure before administering
- B. Monitor for changes in behavior
- C. Observe for paradoxical bronchospasms
- D. Both A and C
Correct Answer: D
Rationale: The correct nursing interventions to perform when a patient is on Albuterol include assessing the patient's lung sounds, pulse, and blood pressure before administering the medication to monitor for cardiovascular side effects like increased heart rate. Additionally, it is crucial to observe for paradoxical bronchospasms, a rare but serious adverse reaction where the medication causes a worsening of bronchospasm instead of relief. Monitoring for changes in behavior is not directly related to Albuterol administration and is not a standard nursing intervention for patients receiving this medication, making choice B incorrect. Therefore, the correct answer is D as it includes the essential nursing actions for patients on Albuterol.
The nurse is caring for a client receiving tamoxifen (Nolvadex) for breast cancer. Which side effect should the nurse monitor for?
- A. Hot flashes
- B. Hair loss
- C. Nausea
- D. Diarrhea
Correct Answer: A
Rationale: Tamoxifen, an estrogen receptor modulator, treats breast cancer but blocks estrogen in some tissues, causing hot flashes , a common menopausal-like effect. Monitoring this ensures client comfort and adherence, as it's frequent and distressing. Hair loss is more chemotherapy-related, not tamoxifen. Nausea and diarrhea occur less often and are less specific. Hot flashes align with tamoxifen's anti-estrogenic action, a key consideration in breast cancer management where long-term use is common. This focus aids in symptom management, distinguishing it from cytotoxic effects, making A the priority side effect to monitor.
A client has a new prescription for Verapamil to treat angina. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Muscle pain
- B. Dry cough
- C. Peripheral edema
- D. Increased urination
Correct Answer: C
Rationale: Verapamil, a calcium channel blocker, can cause peripheral edema due to vasodilation. Clients should monitor for this adverse effect characterized by swelling in the extremities. Muscle pain (choice A) is not a common adverse effect of Verapamil. Dry cough (choice B) is more commonly associated with ACE inhibitors. Increased urination (choice D) is not a typical adverse effect of Verapamil. Therefore, the correct answer is monitoring for peripheral edema.
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.