A client receiving nitrofurantoin (Macrodantin) calls the health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Cough and chest pain. Nitrofurantoin is known to cause serious side effects such as pulmonary toxicity, which can manifest as cough and chest pain. These symptoms indicate a potentially severe adverse reaction that requires immediate medical attention and discontinuation of the medication to prevent further complications. Option A) Nausea is a common side effect of nitrofurantoin but does not typically warrant discontinuation of the medication unless it is severe or persistent. Option B) Diarrhea is another common side effect that may improve with symptomatic treatment or dose adjustment without requiring cessation of therapy. Option C) Anorexia is not a typical side effect associated with nitrofurantoin and would not necessitate stopping the medication based on this symptom alone. From an educational perspective, it is crucial for healthcare providers to be aware of the potential serious side effects of medications like nitrofurantoin to ensure patient safety. Understanding the specific adverse reactions associated with each medication is essential for timely identification and appropriate management of side effects to optimize patient outcomes. In this case, recognizing the significance of cough and chest pain as potential indicators of pulmonary toxicity highlights the importance of thorough assessment and prompt intervention in clinical practice.

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.

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.

Correct Answer: A

Rationale: In assessing the effectiveness of leflunomide (Arava) in a client with rheumatoid arthritis, the nurse should ask, "Do you have any joint pain?" This question is crucial because leflunomide is a disease-modifying antirheumatic drug (DMARD) used to treat rheumatoid arthritis by reducing joint pain, swelling, and inflammation. By inquiring about joint pain, the nurse can determine if the medication is effectively managing the client's symptoms. The other options (B) Are you having any diarrhea? (C) Do you have frequent headaches? and (D) Are you experiencing heartburn? are not directly related to the expected outcomes of leflunomide therapy. Diarrhea is a known side effect of leflunomide, but it is not the primary indicator of effectiveness. Headaches and heartburn are also not typically associated with the therapeutic effects of leflunomide in managing rheumatoid arthritis. Educationally, this question emphasizes the importance of understanding the expected therapeutic outcomes of medications in pharmacology. It highlights the significance of assessing specific symptoms related to the medication's mechanism of action to evaluate its effectiveness accurately. Nurses need to develop critical thinking skills to ask targeted questions that align with the pharmacological principles of the drugs being administered to provide optimal patient care.

Correct Answer: D

Rationale: When a pregnant client receiving intravenous magnesium sulfate for preeclampsia management exhibits absent deep tendon reflexes, this indicates magnesium toxicity. Magnesium toxicity can occur as a complication of magnesium sulfate therapy, leading to suppressed reflexes. It is crucial for the nurse to recognize this sign promptly and report it to prevent further complications or harm to the client.