The nurse has completed medication education with the patient who is receiving lithium (Eskalith). What is the priority patient outcome?
- A. The patient will be able to work a normal work schedule and will receive adequate sleep
- B. The patient will identify signs of lithium (Eskalith) toxicity and verbalize measures to avoid it
- C. The patient will engage in activities of daily living and report enjoyment with them
- D. The patient will report stabilization of mood, including absence of mania or depression
Correct Answer: B
Rationale: Lithium toxicity (e.g., tremors, confusion) at narrow therapeutic range (0.6-1.2) is life-threatening-knowing signs (e.g., nausea) and prevention (e.g., hydration) is priority, per safety. Work, ADLs, and mood stability follow but aren't immediate risks. Toxicity awareness saves lives, per education.
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When starting a new prescription for prednisone, which instruction should the nurse include for the client?
- A. Increase your intake of potassium-rich foods.
- B. Do not stop taking this medication abruptly.
- C. Avoid grapefruit juice while taking this medication.
- D. Take the medication at bedtime to prevent drowsiness.
Correct Answer: B
Rationale: The correct instruction for a client starting a new prescription for prednisone is not to stop taking the medication abruptly. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, emphasizing the importance of gradual tapering under healthcare provider guidance. Increasing potassium-rich foods may be necessary based on individual needs, but it is not the priority instruction in this context. Grapefruit juice interaction is more commonly associated with certain medications but not specifically with prednisone. Taking prednisone at bedtime to prevent drowsiness is not a key instruction related to its administration.
Which of the following antiparkinsonian drugs may cause vasospasm?
- A. Amantadine
- B. Bromocriptine
- C. Carbidopa
- D. Entacapone
Correct Answer: B
Rationale: Bromocriptine, a dopamine D2 agonist used in Parkinson's, has ergot alkaloid properties, which can cause vasospasm by stimulating vascular smooth muscle receptors, occasionally leading to Raynaud's-like symptoms or digital ischemia. Amantadine, an NMDA antagonist, enhances dopamine release but lacks vasoconstrictive effects. Carbidopa inhibits dopa decarboxylase, aiding levodopa delivery without vascular impact. Entacapone, a COMT inhibitor, extends levodopa's duration but doesn't affect vessels. Ropinirole, a non-ergot agonist, avoids vasospasm. Bromocriptine's ergot-derived vasoconstriction, though rare, distinguishes it among antiparkinsonian drugs, requiring caution in patients with vascular risks.
The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which intravenous solution is correct for use with the PRBC transfusion?
- A. 5% dextrose in water (D5W)
- B. 0.9% sodium chloride (NS)
- C. 5% dextrose in 0.45% sodium chloride (D5NS)
- D. 5% dextrose in lactated Ringer™s solution (D5LR)
Correct Answer: B
Rationale: 0.9% sodium chloride (NS), also known as normal saline, is the correct intravenous solution to use with packed red blood cell (PRBC) transfusion. NS is isotonic and compatible with blood products, making it the preferred solution for blood transfusions to prevent hemolysis of red blood cells. Other solutions such as D5W, D5NS, and D5LR are not recommended for use with PRBC transfusions due to their potential to cause hemolysis or affect the stability of the blood product.
Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?
- A. Excessive doxorubicin can result in myelosuppression.
- B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
- C. An excess amount of doxorubicin can lead to cardiomyopathy.
- D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.
Correct Answer: C
Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.
A client starting highly active antiretroviral therapy (HAART) for HIV infection is being educated by a nurse on preventing medication resistance. What information should the nurse provide the client about resistance?
- A. Taking low dosages of antiretroviral medication minimizes resistance.
- B. Taking one antiretroviral medication at a time minimizes resistance.
- C. Taking medication at the same time daily without missing doses minimizes resistance.
- D. Changing the medication regimen when adverse effects occur minimizes resistance.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.