Nokea
The LPN participates in a home visit for a client with Type 2 Diabetes who has been taking Metformin for 3 years. The client states that for the past 3 months, they have been trying a vegan diet and experiencing fatigue, confusion, and mood changes. What is a likely cause of the new symptoms?
- A. vitamin B12 deficiency
- B. chronic hypoglycemia
- C. vitamin D deficiency
- D. increased tolerance to Metformin
Correct Answer: A
Rationale: Long-term use of Metformin can lead to vitamin B12 deficiency, and a vegan diet is low in vitamin B12. Symptoms of vitamin B12 deficiency include anemia, fatigue, confusion, and mood changes.
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The nurse is reviewing client information for adverse effects of trazodone. Which finding should the nurse identify as an adverse effect unique to trazodone?
- A. Priapism
- B. Weight gain
- C. Hepatic failure
- D. Cardiac dysrhythmias
Correct Answer: A
Rationale: Prolonged or inappropriate erections (priapism) are a rare but problematic side effect of treatment with trazodone (Oleptro).
During surgery, it is found that a client with adenocarcinoma of the rectum has positive peritoneal lymph nodes. What is the next most likely site of metastasis?
- A. Brain
- B. Bone
- C. Liver
- D. Mediastinum
Correct Answer: C
Rationale: Rectal adenocarcinoma commonly metastasizes to the liver via the portal vein and lymphatics, making it the most likely next site.
A client who is newly diagnosed with Parkinson's disease and beginning medication therapy asks the nurse, 'How soon will I see improvement?' The nurse's best response is:
- A. That varies from client to client
- B. You should discuss that with your physician
- C. You should notice a difference in a few days
- D. It might take several weeks before you notice improvement
Correct Answer: D
Rationale: Parkinson's medications often take several weeks to show improvement, as they gradually adjust neurotransmitter levels to manage symptoms.
The client with ulcerative colitis is started on sulfasalazine. The nurse overhears the client talking with family members about sulfasalazine and recognizes the need for more teaching when the client makes which statement?
- A. I'll be taking sulfasalazine to help control my diarrhea.
- B. Sulfasalazine will decrease the inflammation in my colon.
- C. After a year of taking sulfasalazine, I'll be cured of the disease.
- D. Sulfasalazine will help to prevent exacerbations of my disease.
Correct Answer: C
Rationale: A: Sulfasalazine reduces inflammation and thereby will reduce the number of diarrheal stools. B: Sulfasalazine, commonly used to treat ulcerative colitis, decreases inflammation in the colon. C: This statement indicates the client needs additional teaching. Ulcerative colitis is a chronic illness. Sulfasalazine (Azulfidine) does not cure ulcerative colitis; the only cure is a total proctocolectomy. D: Sulfasalazine reduces inflammation and thereby will reduce the incidence of flare-ups from ulcerative colitis.
Nursing care for a client undergoing chemotherapy includes assessment for signs of bone marrow depression. Which finding accounts for some of the symptoms related to bone marrow depression?
- A. erythrocytosis
- B. leukocytosis
- C. polycythemia
- D. thrombocytopenia
Correct Answer: D
Rationale: Thrombocytopenia is an abnormal decrease in the number of platelets, which results in bleeding tendencies. Erythrocytosis is an abnormal increase in the number of circulating red blood cells. Leukocytosis is an increase in the number of white blood cells in the blood. Polycythemia is also an excess of red blood cells and is a synonym for erythrocytosis. With chemotherapy there is a decrease in red and white blood cells, not an increase.