Nokea
Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for:
- A. Increased seizure activity, as this drug may auto-induce seizures
- B. Altered renal function, including renal failure
- C. Blood dyscrasias, which are uncommon but possible
- D. Central nervous system excitement, leading to insomnia
Correct Answer: C
Rationale: Ethosuximide can rarely cause blood dyscrasias, requiring monitoring.
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A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy? (Select one that does not apply.)
- A. Hypertension
- B. Coffee-ground emesis
- C. Tinnitus
- D. Nausea
Correct Answer: A
Rationale: Aspirin can cause GI bleeding , tinnitus , and nausea ; 'possessias' is likely a typo.
The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?
- A. Diarrhea
- B. Hair loss
- C. Chest pain
- D. Numbness and tingling in the fingers and toes
Correct Answer: D
Rationale: A side effect specific to vincristine is peripheral neuropathy, which occurs in almost every client. Peripheral neuropathy can be manifested as numbness and tingling in the fingers and toes. Depression of the Achilles tendon reflex may be the first clinical sign indicating peripheral neuropathy. Constipation rather than diarrhea is most likely to occur with this medication, although diarrhea may occur occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest pain is unrelated to this medication.
Information technology can also be used for patient teaching during the encounter and after it. The provider can help patients and their families become savvy consumers of health-care information by:
- A. Warning them about the questionable quality of health information online
- B. Identifying easily used 'apps' that patients can use to manage their medications
- C. Teaching them how to identify high-quality Web sites and 'red flags' signaling inaccurate content
- D. All of the above
Correct Answer: D
Rationale: All these strategies help patients navigate health information effectively.
A client has an order to receive 10 units of intermediate-acting insulin at bedtime via subcutaneous injection. The nurse would expect to administer the injection at which site? Select one that does not apply.
- A. Upper arm
- B. Inner forearm
- C. Upper abdomen
- D. Upper thigh
Correct Answer: B
Rationale: The sites for subcutaneous injection are the upper arms, the upper abdomen, and the upper thighs.
A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:
- A. Decreased effectiveness of irinotecan in the treatment of cancer
- B. Increased adverse drug reactions, such as neutropenia
- C. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
- D. Increased concerns for irinotecan being carcinogenic
Correct Answer: B
Rationale: UGT1A1 mutations slow SN-38 inactivation, raising neutropenia risk , not affecting efficacy or activation .