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A nurse is teaching about adverse effects of anastrozole with a client who has advanced breast cancer and is postmenopausal. Which of the following adverse effects should the nurse recommend the client report to the provider?
- A. Fatigue
- B. Hot flashes
- C. Musculoskeletal pain
- D. Nausea
Correct Answer: C
Rationale: The correct answer is C: Musculoskeletal pain. Anastrozole, an aromatase inhibitor used in breast cancer treatment, can cause musculoskeletal pain as a common adverse effect. This is important to report to the provider as it may indicate musculoskeletal issues such as osteoporosis or arthritis. Fatigue (A) and hot flashes (B) are common side effects of anastrozole but not typically indicative of serious issues requiring immediate attention. Nausea (D) is also a common side effect but is usually manageable and not a significant concern unless severe. It is crucial for the nurse to prioritize musculoskeletal pain as a potential indicator of more serious complications.
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A client is receiving treatment for stage IV ovarian cancer and asks the nurse to discuss her prognosis. The client plans to have aggressive surgical, radiation, and chemotherapy treatments. Which of the following prognoses should the nurse discuss with the client?
- A. Good
- B. Excellent
- C. Fair
- D. Poor
Correct Answer: D
Rationale: The correct answer is D: Poor. In stage IV ovarian cancer, the cancer has spread beyond the ovaries to distant organs. Prognosis is generally poor due to the advanced stage of the disease. Aggressive treatments can help manage symptoms and improve quality of life but are unlikely to cure the cancer. Discussing a poor prognosis with the client allows for realistic expectations and informed decision-making. Choices A, B, and C are incorrect as they suggest a better prognosis which is not typical for stage IV ovarian cancer.
A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make?
- A. DIC is caused by abnormal coagulation involving fibrinogen.
- B. DIC is caused by increased fibrinogen levels.
- C. DIC is caused by a reduction in platelet production.
- D. DIC is caused by a decrease in clotting factors.
Correct Answer: A
Rationale: The correct answer is A because DIC is characterized by abnormal coagulation involving fibrinogen. In septic shock, the body's response triggers widespread activation of the coagulation system, leading to the consumption of clotting factors like fibrinogen. This results in the formation of microclots throughout the body, leading to organ dysfunction. Choices B, C, and D are incorrect as DIC is not caused by increased fibrinogen levels, a reduction in platelet production, or a decrease in clotting factors. It is essential for the nurse to emphasize the role of abnormal coagulation involving fibrinogen in DIC to help the client understand the pathology and potential complications associated with septic shock.
A nurse is caring for a client who has heart failure and a new prescription for furosemide. For which of the following adverse effects should the nurse monitor?
- A. Hypokalemia
- B. Hyperkalemia
- C. Hypernatremia
- D. Hypertension
Correct Answer: A
Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that can cause potassium loss through increased urine output. This can lead to hypokalemia, which can be dangerous in a client with heart failure as it can worsen cardiac function and lead to arrhythmias. The nurse should monitor the client's potassium levels regularly to prevent this adverse effect.
Summary of other choices:
B: Hyperkalemia - Furosemide does not typically cause hyperkalemia.
C: Hypernatremia - Furosemide is a diuretic that can lead to sodium loss, not hypernatremia.
D: Hypertension - Furosemide is actually used to treat hypertension, so it is not an adverse effect of the medication in this scenario.
A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for?
- A. Decreased potassium level
- B. Increased sodium level
- C. Increased calcium level
- D. Decreased magnesium level
Correct Answer: A
Rationale: The correct answer is A: Decreased potassium level. Postoperative ileus can lead to gastrointestinal fluid losses, causing a decrease in potassium levels due to excessive drainage through the NG tube. Potassium is an important electrolyte for maintaining normal muscle function, including the heart. Monitoring potassium levels is essential to prevent complications such as cardiac arrhythmias.
Incorrect choices:
B: Increased sodium level - Unlikely in this scenario as excessive drainage would lead to fluid and electrolyte loss.
C: Increased calcium level - Unrelated to postoperative ileus and NG tube drainage.
D: Decreased magnesium level - Possible but not as critical as monitoring potassium levels in this situation.
A nurse assesses a client in skeletal traction. What indicates infection at the pin sites?
- A. Pallor
- B. Fever
- C. Bradycardia
- D. Elevated blood pressure
Correct Answer: B
Rationale: The correct answer is B: Fever. Infection at the pin sites in skeletal traction commonly presents with systemic signs like fever. Fever is a typical response to infection as the body tries to fight off the invading pathogens. Pallor, bradycardia, and elevated blood pressure are not specific indicators of infection at pin sites. Pallor may indicate poor perfusion, bradycardia is a slow heart rate which is not typically associated with infection, and elevated blood pressure can be a response to various stressors but not a specific sign of infection at pin sites. In summary, fever is the most reliable indicator of infection at pin sites due to its systemic nature.