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When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?
- A. Assessing the injection site for itching and edema
- B. Monitoring white blood cell counts and platelet counts
- C. Evaluating for fatigue and joint pain in the client
- D. Checking for a metallic taste in the mouth and loss of appetite
Correct Answer: B
Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.
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A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education?
- A. Constipation and bloating might be a problem.
- B. I'll continue to watch my diet and reduce my fats.
- C. Walking a mile each day will help the whole process.
- D. I'll continue my nicotinic acid from the health food store.
Correct Answer: D
Rationale: Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and cholestyramine resin is to be avoided. Constipation and bloating are the two most common side effects. Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.
A healthcare professional is preparing to administer digoxin (Lanoxin), 0.125 mg orally, to a client with heart failure. Which vital sign is most important for the healthcare professional to check before administering the medication?
- A. Heart rate
- B. Temperature
- C. Respirations
- D. Blood pressure
Correct Answer: A
Rationale: Before administering digoxin, it is essential to assess the client's heart rate as this medication directly affects cardiac function. Monitoring the heart rate helps identify if it is within the acceptable range for administering digoxin. A pulse rate below 60 beats per minute warrants withholding the medication to prevent potential adverse effects like bradycardia or cardiac arrhythmias.
A client with hypertension is prescribed clonidine (Catapres) transdermal patch. Which statement by the client indicates an understanding of the medication?
- A. I should change the patch daily.
- B. I should remove the old patch before applying a new one.
- C. I should avoid alcohol consumption while using this patch.
- D. I should apply the patch to different sites each time.
Correct Answer: B
Rationale: The correct answer is B. The client should remove the old clonidine (Catapres) patch before applying a new one to prevent overdose. The patch is typically changed every 7 days. Avoiding alcohol consumption is important as it can potentiate the sedative effects of clonidine. It is recommended to rotate application sites to prevent skin irritation and ensure optimal drug absorption.
When assessing the effectiveness of leflunomide (Arava) in a client with rheumatoid arthritis, which question should the nurse ask during data collection?
- A. Do you have any joint pain?
- B. Are you having any diarrhea?
- C. Do you have frequent headaches?
- D. Are you experiencing heartburn?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with chronic pain is prescribed transdermal fentanyl (Duragesic) patches. Which instruction should the nurse include in the teaching plan?
- A. Apply the patch to a different site each time.
- B. Avoid using heating pads over the patch.
- C. Change the patch every 72 hours.
- D. Remove the old patch before applying the new one.
Correct Answer: B
Rationale: Clients using transdermal fentanyl (Duragesic) patches should avoid using heating pads over the patch as heat can increase the release of the medication, potentially leading to overdose. The patch should be applied to a different site each time, changed every 72 hours, and the old patch should be removed before applying a new one to prevent accidental overdose or excessive drug absorption.