A 43-year-old woman with multiple sclerosis has not been treated with medication because of only having mild symptoms. Now, she has bilateral lower extremity weakness and urinary complaints. She has begun on mitoxantrone. Which of the following adverse effects must the treating physician be aware of?

Correct Answer: B

Rationale: Mitoxantrone for MS progression risks hepatitis . This chemotherapeutic damages liver cells, requiring monitoring. Anxiety , hypopyrexia , muscle strength , and leukocytosis (E) aren't primary. Hepatotoxicity, with cardiotoxicity, is a key concern in this worsening MS case.

Correct Answer: B

Rationale: Carbonic anhydrase inhibitors are a class of medications used to treat edema by decreasing the production of aqueous humor in the eye and reducing fluid in the body. One common side effect of carbonic anhydrase inhibitors is metabolic acidosis, which can lead to increased blood glucose levels in patients with diabetes. The medication may interfere with the body's ability to regulate blood glucose levels, leading to elevated blood glucose. Therefore, when monitoring a patient with diabetes who is receiving a carbonic anhydrase inhibitor, the nurse should closely monitor for signs of elevated blood glucose levels to prevent potential complications.

Correct Answer: C

Rationale: Nystatin is an antifungal medication used to treat fungal infections, such as candidiasis. Before administration, assessing whether the client could be pregnant is critical because nystatin's safety in pregnancy is not fully established (Category C), meaning potential risks to the fetus cannot be ruled out without further evaluation. This makes pregnancy status a key safety consideration to prevent harm to an unborn child, outweighing other factors in urgency. The type of diet or amount of fat might influence general health or drug absorption minimally but isn't directly critical to nystatin's administration. Height and weight could affect dosing in some medications, but nystatin's dosing is typically standard and not weight-based for most fungal infections. Thus, confirming pregnancy status ensures the drug's safety profile aligns with the client's condition, making choice C the most critical assessment data to review prior to administration.

Correct Answer: A

Rationale: Altered nutrition is often the priority nursing diagnosis for clients undergoing chemotherapy because the treatment can cause side effects such as nausea, vomiting, anorexia, and mucositis, leading to malnutrition and weight loss. Proper nutrition is essential for maintaining strength, supporting the immune system, and promoting recovery. While fear, anxiety, and decreased cardiac output are valid concerns, addressing nutritional deficits is critical to the client's overall well-being and ability to tolerate treatment.

Correct Answer: B

Rationale: The persistent dry cough mentioned by the patient is a well-known adverse effect of ACE inhibitors. This side effect is due to the accumulation of bradykinin in the lungs, leading to irritation and stimulation of cough receptors. If a patient taking an ACE inhibitor develops a persistent dry cough, it is essential to notify the healthcare provider to consider alternative antihypertensive medications to manage the hypertension effectively without causing this bothersome side effect.

Correct Answer: A

Rationale: Finasteride, a 5-alpha reductase inhibitor, is used as Proscar for benign prostatic hyperplasia (BPH) and as Propecia for male pattern baldness, reducing dihydrotestosterone to promote hair growth. Without prostate issues, baldness is a likely reason for its use. Erectile dysfunction isn't treated by finasteride-it may cause it-making that irrelevant. Stomach ulcers and hypertension aren't linked to finasteride's androgen-targeted action. Asking about baldness probes a condition tied to its alternative use, clarifying the prescription's purpose and guiding the nurse's understanding of the client's therapy.

Correct Answer: C

Rationale: Ace Inhibitors generally end in the suffix "-pril". This class of medications works by inhibiting the angiotensin-converting enzyme (ACE), leading to relaxation of blood vessels and decreased blood pressure. Common examples of ACE inhibitors include enalapril, lisinopril, and captopril.

Correct Answer: A

Rationale: Enalapril, an ACE inhibitor, causes dry cough via bradykinin buildup, a common effect needing reporting to consider switching (e.g., to an ARB). Fatigue , headache , and nausea are less specific or urgent. Cough aligns with enalapril's pharmacology, critical in hypertension where adherence hinges on tolerability, making A the key side effect to report.

Correct Answer: A

Rationale: The patient's symptoms-runny nose and itchy eyes during spring-suggest seasonal allergic rhinitis, where histamine is the main chemical mediator released from mast cells. Cromolyn sodium stabilizes mast cells, preventing histamine release, making it a prophylactic agent ideal for this scenario. Diphenhydramine is an H1 antihistamine that blocks histamine receptors after release, not preventing its release, so it's incorrect. Ranitidine is an H2 blocker, affecting gastric acid secretion, not allergic histamine pathways. Loratadine is another H1 antihistamine, also acting post-release. Theophylline (E) is a bronchodilator, irrelevant here. The question emphasizes preventing release, not blocking effects, so Cromolyn sodium stands out. Its mechanism directly addresses the root cause by stabilizing mast cells before allergen exposure triggers histamine release, offering a preventative rather than symptomatic approach, which aligns with the patient's recurring seasonal issue.