a nurse is teaching a client who has breast cancer about tamoxifen which of the following adverse effects of tamoxifen should the nurse discuss with t

ATI RN

ATI Proctored Pharmacology 2023

1. A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?

A. Irregular heart rhythm
B. Abnormal uterine bleeding
C. Yellowing of the sclera or dark-colored urine
D. Difficulty swallowing

Correct answer: B

Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.

2. A client has a new prescription for Allopurinol. Which of the following instructions should the nurse include?

A. Take this medication at bedtime.
B. Increase your fluid intake.
C. Avoid foods high in calcium.
D. Take this medication with meals.

Correct answer: B

Rationale: Allopurinol can cause kidney stones due to the formation of uric acid crystals, so it is crucial for the client to increase their fluid intake. Adequate hydration helps to prevent the formation of kidney stones by diluting the urine and promoting the excretion of uric acid. Therefore, advising the client to increase their fluid intake is essential in preventing this adverse effect while taking Allopurinol.

3. What is the pharmacological action of metformin?

A. Blocks stimulation of beta1 and beta2.
B. Blocks vasoconstriction and aldosterone.
C. Acts at many levels in the CNS to produce an anxiolytic effect.
D. Decreases hepatic glucose production.

Correct answer: D

Rationale: The correct answer is D: Decreases hepatic glucose production. Metformin's primary pharmacological action is to decrease hepatic glucose production, leading to lower blood sugar levels and improved insulin sensitivity in the liver. Choices A, B, and C are incorrect because metformin does not block stimulation of beta1 and beta2 receptors, vasoconstriction, aldosterone, or act in the CNS to produce an anxiolytic effect. Therefore, these options are not reflective of metformin's mechanism of action.

4. A client has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

A. Sedation
B. Nasal congestion
C. Productive cough
D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. After more than 5 days of use, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion. This occurs due to prolonged vasoconstriction of nasal blood vessels, causing worsening nasal congestion. Sedation (choice A) is not a common adverse effect of phenylephrine nasal drops. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with this medication.

5. Which of the following is not a side effect of Sympathoplegics (Clonidine)?

A. Hypertension
B. Difficulty breathing
C. Dry oral cavity
D. Lethargic behavior

Correct answer: A

Rationale: The correct answer is A. Clonidine, a Sympathoplegic, typically causes hypotension rather than hypertension. The other side effects associated with Clonidine include dry oral cavity, lethargic behavior, and difficulty breathing, making them incorrect choices in this context.