Nokea
Phenytoin is prescribed for a client who has a seizure disorder. Which statement by the client needs to be clarified by the healthcare provider?
- A. I should notify the healthcare provider if the color of my urine turns pink.
- B. I should never stop taking this medication abruptly.
- C. I should monitor my glucose levels closely since I am diabetic.
- D. I should take the medicine with antacids if gastric upset occurs.
Correct Answer: D
Rationale: The correct answer is D because antacids should not be taken with phenytoin as they can decrease its effects. Taking antacids with phenytoin is not recommended. Choice A is correct; pink discoloration of urine can occur with phenytoin use. Choice B is also correct; abruptly stopping phenytoin can lead to seizures. Choice C is correct; monitoring glucose levels is important as phenytoin can increase glucose levels. Therefore, the statement about using antacids with phenytoin needs clarification.
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A client with major depressive disorder is prescribed bupropion. Which statement by the client indicates the need for further teaching?
- A. This medication may cause weight gain.
- B. This medication may take several weeks to take effect.
- C. I should avoid alcohol while taking this medication.
- D. I should take this medication in the morning with food.
Correct Answer: A
Rationale: The correct answer is A because bupropion is associated with weight loss rather than weight gain. It is important for the client to be aware of this potential side effect. Choice B is correct because bupropion may take several weeks to exhibit its full therapeutic effects. Choice C is also accurate as alcohol consumption should be avoided while taking bupropion due to the risk of seizures. Choice D is correct as taking bupropion in the morning with food can help reduce the risk of gastrointestinal side effects.
A practical nurse (PN) is providing education to a client who is starting therapy with metformin for type 2 diabetes. What side effect should the client be instructed to report to the healthcare provider?
- A. Weight gain
- B. Hypoglycemia
- C. Muscle pain
- D. Nausea
Correct Answer: D
Rationale: The correct answer is 'Nausea.' Nausea is a common side effect of metformin, especially when the medication is first started. It is essential for the client to report persistent or severe nausea to the healthcare provider for further evaluation and management. Weight gain (Choice A) is not a typical side effect of metformin; in fact, metformin is associated with weight loss or weight neutrality. Hypoglycemia (Choice B) is a potential side effect of some diabetes medications, but metformin does not typically cause hypoglycemia. Muscle pain (Choice C) is not a common side effect of metformin; it is more commonly associated with other medications like statins.
A client with chronic pain is prescribed oxycodone. What instruction should the practical nurse (PN) include in the client's teaching plan?
- A. Take the medication with meals to avoid gastrointestinal upset.
- B. Avoid taking the medication with alcohol.
- C. Increase fluid intake to avoid constipation.
- D. Report any signs of respiratory depression to the healthcare provider.
Correct Answer: B
Rationale: The correct answer is to instruct the client to avoid taking oxycodone with alcohol. Mixing oxycodone with alcohol can lead to serious side effects, including respiratory depression. Taking the medication with meals may not always be necessary, and instructions about fluid intake to avoid constipation are important but not the priority when considering the immediate risks associated with oxycodone. While reporting signs of respiratory depression is crucial, preventing it by avoiding alcohol is key in the client's safety.
A client with a history of heart failure is prescribed carvedilol. The nurse should monitor the client for which adverse effect?
- A. Dizziness upon standing
- B. Weight loss
- C. Bradycardia
- D. Hypotension
Correct Answer: D
Rationale: The correct answer is D: Hypotension. Carvedilol, a beta-blocker, can lead to hypotension by blocking the effects of adrenaline, which can cause blood vessels to dilate and reduce blood pressure. While dizziness upon standing is a potential adverse effect of carvedilol, it is more specifically related to orthostatic hypotension, which is a form of hypotension that occurs when a person stands up from a sitting or lying position. Weight loss and bradycardia are not typically associated with carvedilol use. Therefore, the nurse should primarily monitor for hypotension in a client taking carvedilol.
A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines the client has been self-administering St. John's wort, an herbal preparation, on the advice of a friend. What information is most significant about this finding?
- A. Wort can decrease plasma concentration of Cyclospora
- B. Wort can decrease plasma concentration of Tacrolimus
- C. Wort can decrease plasma concentration of Cyclosporine
- D. Wort can decrease plasma concentration of Mycophenolate
Correct Answer: C
Rationale: The most significant information about the client self-administering St. John's wort, an herbal preparation, is that it can decrease the plasma concentration of Cyclosporine. St. John's wort is known to reduce the efficacy of Cyclosporine, which is a common immunosuppressant drug used to prevent transplant rejection. Choices A, B, and D are incorrect because St. John's wort does not affect the plasma concentration of Cyclospora, Tacrolimus, or Mycophenolate.