Nokea
The client with cancer has an order for Adriamycin. Which of the following untoward effects is of particular concern to the nurse?
- A. Alopecia
- B. Fatigue
- C. Dysrhythmias
- D. Nausea
Correct Answer: C
Rationale: Adriamycin (doxorubicin) is cardiotoxic, and dysrhythmias are a serious concern. Alopecia, fatigue, and nausea are common but less life-threatening.
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A client who has a strong family history of breast cancer tells the nurse that she is taking a drug to prevent breast cancer. The nurse expects the drug that she is receiving is:
- A. Tamoxifen (Nolvadex)
- B. Cyclophosphamide (Cytoxan)
- C. Estrogen (Premarin)
- D. Doxorubicin (Adriamycin)
Correct Answer: A
Rationale: Tamoxifen is used for breast cancer prevention in high-risk individuals due to its anti-estrogenic effects. Cyclophosphamide and Doxorubicin are chemotherapy drugs, not preventive, so B and D are incorrect. Estrogen can increase breast cancer risk, making C incorrect.
The nurse is assigned to care for a client who has a leaking intracranial aneurysm. To minimize the risk of rebleeding, the nurse should plan to
- A. restrict visitors to immediate family
- B. avoid arousal of the client except for family visits
- C. keep client's hips flexed at no less than 90 degrees
- D. apply a warming blanket for temperatures of 98 degrees Fahrenheit or less
Correct Answer: A
Rationale: restrict visitors to immediate family. Maintaining a quiet environment will assist in minimizing cerebral rebleeding. When family visit, the client should not be disturbed. If the client is awake, topics of a general nature are better choices for discussion than topics that result in emotional or physiological stimulation.
The nurse is caring for a patient admitted two days ago with a diagnosis of closed head injury. If the patient develops diabetes insipidus, the nurse would observe which of the following symptoms?
- A. Decerebrate posturing, BP 160/100, pulse 56.
- B. Cracked lips, urinary output of 4 L/24 h with a specific gravity of 1.004.
- C. Glucosuria, osmotic diuresis, loss of water and electrolytes.
- D. Weight gain of 5 lb, pulse 116, serum sodium 110 mEq/L.
Correct Answer: B
Rationale: signs of dehydration, increased output, low specific gravity, normal 1.010-1.030
The client who is receiving hydantoin (Dilantin) tells the nurse his urine is pink-colored. What action should the nurse take?
- A. Report this serious side effect immediately to the physician
- B. Reassure the client that this occurs often in persons taking Dilantin
- C. Ask the client if he drank cranberry juice or ate red gelatin recently
- D. Strain the client's urine for possible urinary tract stones
Correct Answer: C
Rationale: Pink urine may result from dietary factors like cranberry juice or red gelatin, which should be ruled out before assuming a Dilantin-related issue.
The nurse is caring for clients in the diabetic clinic.
Which of the following clients should the nurse see FIRST?
- A. A client with sunken eyeballs and a fruity breath odor.
- B. A client who complains of pain in his calves when he exercises.
- C. A client who states that she drinking liquids frequently and is always hungry.
- D. A client says that she is having difficulty sleeping and cries frequently.
Correct Answer: A
Rationale: Strategy: Determine the least stable client. (1) correct-indicates diabetic ketoacidosis; treat with normal saline and regular insulin (2) suggestive of intermittent claudication, not an emergency situation (3) suggestive of hyperglycemia, should assess blood sugar (4) psychosocial issues, physical takes priority