Nokea
While collecting data from a client taking Gemfibrozil, a nurse should identify which of the following assessment findings as an adverse reaction to the medication?
- A. Mental status changes
- B. Tremor
- C. Jaundice
- D. Pneumonia
Correct Answer: C
Rationale: Jaundice is an adverse reaction that the nurse should identify when assessing a client taking Gemfibrozil. It is associated with liver impairment, which can be a side effect of this medication. Mental status changes and tremors are not typically associated with Gemfibrozil use. Pneumonia is not a common adverse reaction to this medication, and its occurrence is not directly linked to Gemfibrozil use.
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A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?
- A. Contact provider if heart rate is less than 60/min.
- B. Check pulse rate for 30 seconds and multiply the result by 2.
- C. Increase intake of sodium.
- D. Take with food if nausea occurs.
Correct Answer: A
Rationale: The correct instruction for a client prescribed Digoxin for heart failure is to contact the provider if the heart rate is less than 60/min. Digoxin can affect heart rate, and a heart rate below 60/min may indicate toxicity, requiring prompt medical attention. Checking the pulse rate accurately and seeking medical advice are essential components of safe medication management. Choices B, C, and D are incorrect. Choice B is related to checking the pulse rate but does not address the critical action of contacting the provider if it is below 60/min. Increasing intake of sodium (Choice C) is inappropriate as high sodium levels can worsen heart failure. Taking Digoxin with food if nausea occurs (Choice D) does not address a critical aspect of Digoxin administration related to heart rate monitoring.
A client has a new prescription for Hydrochlorothiazide. Which of the following adverse effects should the nurse monitor?
- A. Hyponatremia
- B. Hyperkalemia
- C. Hypercalcemia
- D. Hypoglycemia
Correct Answer: A
Rationale: Corrected Rationale: Hydrochlorothiazide, a diuretic, can lead to electrolyte imbalances, particularly hyponatremia (low sodium levels). The nurse should closely monitor the client's sodium levels due to the potential adverse effect of Hydrochlorothiazide.
Incorrect Rationales:
- Hyperkalemia (Choice B) is less likely to be caused by Hydrochlorothiazide; in fact, it can lead to hypokalemia.
- Hypercalcemia (Choice C) is not a common adverse effect of Hydrochlorothiazide.
- Hypoglycemia (Choice D) is not directly associated with Hydrochlorothiazide use.
A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?
- A. Administering a supplemental dose of hydrocortisone
- B. Instructing the client about coughing and deep breathing
- C. Collecting additional information from the client about his history of Addison's disease
- D. Inserting an indwelling urinary catheter
Correct Answer: A
Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.
A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?
- A. One
- B. Two
- C. Three
- D. Four
Correct Answer: A
Rationale: Phenobarbital, with a long half-life of 4 days, remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should administer phenobarbital once a day to maintain a consistent therapeutic effect without the need for multiple daily doses. Administering the medication more than once a day would not be necessary and could increase the risk of side effects or toxicity. Therefore, the correct answer is to administer phenobarbital once a day.
A healthcare professional is caring for a client who has a new prescription for Lisinopril. Which of the following laboratory values should the professional monitor?
- A. Serum potassium
- B. Serum sodium
- C. Serum calcium
- D. Serum magnesium
Correct Answer: A
Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing the excretion of potassium in the kidneys. Monitoring serum potassium levels is essential to prevent complications such as cardiac arrhythmias. Therefore, the healthcare professional should closely monitor the client's serum potassium levels when they are on Lisinopril. Choices B, C, and D are incorrect because Lisinopril primarily affects potassium levels due to its mechanism of action as an ACE inhibitor. Serum sodium, calcium, and magnesium levels are not typically affected by Lisinopril in the same way as potassium.