Nokea
When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?
- A. Serum hepatic enzymes
- B. Fingerstick glucose
- C. Stool color and character
- D. Serum electrolytes and ammonia
Correct Answer: D
Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition.
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A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?
- A. Apical heart rate of 60 beats/min
- B. Sweating across the forehead
- C. Poor sucking effort
- D. Respiratory rate of 30 breaths/min
Correct Answer: A
Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects.
A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse (PN) reinforce to this client?
- A. Maintain consistent sodium intake.
- B. Use sunscreen when outdoors.
- C. Return for monthly urinalysis.
- D. Brush and floss teeth daily.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with chronic kidney disease is prescribed sevelamer carbonate. The nurse should monitor for which potential side effect?
- A. Hypercalcemia
- B. Hypocalcemia
- C. Hyperkalemia
- D. Hypokalemia
Correct Answer: A
Rationale: When a client with chronic kidney disease is prescribed sevelamer carbonate, the nurse should monitor for hypercalcemia as a potential side effect. Sevelamer carbonate can bind to dietary calcium and impair its absorption, potentially leading to elevated calcium levels in the blood. Monitoring calcium levels is crucial to detect and manage hypercalcemia promptly.
The practical nurse administered carbidopa-levodopa to a client diagnosed with Parkinson's disease. Which outcome by the client would indicate a therapeutic response?
- A. Decreased blood pressure
- B. Lessening of tremors
- C. Increased salivation
- D. Increased attention span
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. The nurse should instruct the client to report which potential side effect?
- A. Dry mouth
- B. Blurred vision
- C. Nausea
- D. Tachycardia
Correct Answer: A
Rationale: The correct answer is A: Dry mouth. Tiotropium, a commonly prescribed medication for COPD, can cause dry mouth as a side effect. While it may not be severe, clients should report it if it becomes bothersome. Blurred vision, nausea, and tachycardia are not typically associated with tiotropium use in the context of COPD.