Nokea
The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:
- A. Take the medication with food.
- B. Increase fluid intake to 2000 to 3000 mL daily.
- C. Decrease sodium intake while taking the medication.
- D. Increase potassium intake while taking the medication.
Correct Answer: B
Rationale: The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.
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Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication?
- A. To take the medication after meals
- B. To return to the clinic weekly for serum drug-level testing
- C. To call the health care provider (HCP) if a skin rash occurs
- D. To restrict alcohol intake with this medication
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the teaching plan?
- A. Use the medication as a rescue inhaler.
- B. Rinse your mouth after using the inhaler.
- C. Take the medication on an empty stomach.
- D. Take the medication with a full glass of water.
Correct Answer: B
Rationale: Tiotropium (Spiriva) is not a rescue inhaler but a maintenance medication for COPD. The correct instruction for the nurse to include in the teaching plan is to advise the client to rinse their mouth after using the inhaler. This practice helps prevent dry mouth and throat irritation, common side effects of tiotropium. There are no specific recommendations to take tiotropium on an empty stomach or with a full glass of water.
A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A healthcare provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?
- A. 3 to 5 ng/mL
- B. 0.5 to 2 ng/mL
- C. 1.2 to 2.8 ng/mL
- D. 3.5 to 5.5 ng/mL
Correct Answer: B
Rationale: The therapeutic serum level for digoxin ranges from 0.5 to 2 ng/mL. This range is considered optimal for therapeutic effects while minimizing the risk of toxicity. Levels above 2 ng/mL may lead to digoxin toxicity, which can manifest as anorexia among other symptoms. Therefore, the nurse should be vigilant in monitoring the digoxin levels to ensure the client's safety and therapeutic effectiveness of the medication.
A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?
- A. Monitor for renal failure.
- B. Monitor psychosocial status.
- C. Monitor for signs of bleeding.
- D. Have heparin sodium available.
Correct Answer: C
Rationale: The priority nursing intervention for a client receiving tissue plasminogen activator (alteplase) for an acute myocardial infarction is to monitor for signs of bleeding. Alteplase is a thrombolytic medication that can lead to hemorrhage as a complication. Therefore, closely monitoring the client for any signs of bleeding is essential to promptly address and manage this potential adverse effect.
The healthcare provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatment?
- A. The medication is an antibacterial.
- B. The medication will help heal the burn.
- C. The medication will permanently stain my skin.
- D. The medication should be applied directly to the wound.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.