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The nurse is caring for a client with a history of breast cancer who is receiving tamoxifen (Nolvadex). The nurse should monitor the client for which of the following adverse effects?
- A. Endometrial cancer.
- B. Hypocalcemia.
- C. Alopecia.
- D. Weight loss.
Correct Answer: A
Rationale: Tamoxifen increases the risk of endometrial cancer, requiring monitoring for abnormal vaginal bleeding.
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A client with a history of bipolar disorder is prescribed carbamazepine (Tegretol). The nurse should monitor the client for which of the following side effects?
- A. Weight loss.
- B. Agranulocytosis.
- C. Hyperglycemia.
- D. Dry skin.
Correct Answer: B
Rationale: Carbamazepine can cause agranulocytosis, requiring regular monitoring of white blood cell counts.
A client with a history of type 2 diabetes is prescribed exenatide (Byetta). The nurse should instruct the client to:
- A. Take the medication before meals.
- B. Monitor for signs of hypoglycemia.
- C. Take the medication at bedtime.
- D. Stop the medication if weight loss occurs.
Correct Answer: A, B
Rationale: Exenatide is taken before meals to control postprandial glucose, and hypoglycemia is a risk.
An obese diabetic client complains of bilateral leg aching. His physician has referred him to cardiac rehabilitation to start an exercise program. Which of the following activities is most helpful for the client?
- A. Interval training on the stationary bicycle.
- B. Interval training on the treadmill.
- C. Interval training on a commercial ski machine.
- D. Interval training on the stair climber.
Correct Answer: A
Rationale: Stationary cycling is low-impact, suitable for an obese diabetic client, minimizing joint stress while improving cardiovascular health.
The nurse is caring for a client receiving chemotherapy. Which precaution is most important?
- A. Use standard precautions.
- B. Wear a gown and gloves.
- C. Place the client in isolation.
- D. Monitor for fever.
Correct Answer: D
Rationale: Monitoring for fever is critical, as chemotherapy increases infection risk due to immunosuppression.
A client with type 2 diabetes is admitted with a blood glucose level of 450 mg/dL. The nurse should anticipate which of the following orders?
- A. Regular insulin IV
- B. Oral metformin
- C. Glucagon injection
- D. Potassium supplement
Correct Answer: A
Rationale: Hyperglycemia requires regular insulin IV to rapidly lower blood glucose. Metformin is oral and slower, glucagon raises glucose, and potassium is not indicated without further assessment.