Nursing Elites

1. A client taking ethambutol (Myambutol) understands the instructions provided by the nurse if the client states that he or she will immediately report:

• A. Impaired sense of hearing
• B. Problems with visual acuity
• C. Gastrointestinal (GI) side effects
• D. Orange-red discoloration of body secretions

Correct answer: B

Rationale: The correct answer is B: Problems with visual acuity. Ethambutol is known to cause optic neuritis, leading to a decrease in visual acuity and color discrimination. Therefore, any visual changes should be reported promptly to prevent further complications. Choices A, C, and D are incorrect because ethambutol does not typically cause impaired sense of hearing, gastrointestinal side effects, or orange-red discoloration of body secretions. It is crucial for clients taking ethambutol to be aware of potential visual disturbances and report them promptly to healthcare providers.

2. When caring for a client with cancer receiving cisplatin, what adverse effects should the nurse monitor for? Select all that apply.

• A. Tinnitus
• B. Insomnia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: Cisplatin, a chemotherapy medication, can lead to various adverse effects, including ototoxicity manifesting as tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Therefore, the nurse should closely monitor for these side effects during the client's treatment.

3. Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client's health history, knowing that this medication is contraindicated if which of the following disorders is present?

• A. Headaches
• B. Liver disease
• C. Hypothyroidism
• D. Diabetes mellitus

Correct answer: B

Rationale: Carbamazepine (Tegretol) is contraindicated in liver disease due to its potential to cause hepatic toxicity. Regular monitoring of liver function tests is necessary when using this medication to detect any signs of liver damage.

4. A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the healthcare provider's office that a dose was taken this morning. The nurse determines that:

• A. The client should reschedule the appointment.
• B. A lower dose of allergen will need to be injected.
• C. A higher dose of allergen will need to be injected.
• D. The client should have the skin test read a day later than usual.

Correct answer: A

Rationale: Fexofenadine, an antihistamine, can cause false-negative readings in allergy skin testing and should be discontinued 3 days prior. Therefore, the client should reschedule the appointment to ensure accurate test results.

5. Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:

• A. 1 hour after each meal
• B. Once daily, at the same time each day
• C. 15 minutes before breakfast, lunch, and dinner
• D. Before each meal, based on the blood glucose level

Correct answer: B

Rationale: Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.

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