A client with chronic obstructive pulmonary disease (COPD) is receiving prednisone (Deltasone). Which side effect should the nurse monitor for?

Correct Answer: B

Rationale: The correct answer is B: Infection. Prednisone is a corticosteroid that suppresses the immune system, increasing the risk of infections in patients. The nurse should monitor for signs of infection such as fever, increased white blood cell count, and localized symptoms. Rationale: A: Hypoglycemia is not a common side effect of prednisone. Prednisone typically causes hyperglycemia. C: Hypotension is not a common side effect of prednisone. Prednisone can actually cause fluid retention and increased blood pressure. D: Weight loss is not a common side effect of prednisone. Prednisone can actually cause weight gain due to fluid retention and increased appetite.

Correct Answer: C

Rationale: Step-by-step rationale for choice C: 1. Metformin can cause gastrointestinal side effects. 2. Taking it with meals helps reduce stomach upset. 3. It also helps in better absorption and effectiveness. 4. Therefore, the nurse should instruct the patient to take metformin with meals. Summary of other choices: A: Taking on an empty stomach can worsen gastrointestinal side effects. B: Metformin doesn't typically cause hypoglycemia. D: Increasing simple carbohydrates can counteract the effects of metformin.

Correct Answer: B

Rationale: The correct answer is B: Diminished cough effort. In myasthenia gravis, muscle weakness can affect the muscles involved in coughing, leading to diminished cough effort. This can result in ineffective airway clearance, putting the client at high risk for respiratory complications. Pain during coughing (choice A) may occur but is not the primary cause of ineffective airway clearance in myasthenia gravis. Thick, dry secretions (choice C) and excessive inflammation (choice D) may contribute to airway clearance issues but are not as directly related to the underlying muscle weakness seen in myasthenia gravis.

Correct Answer: B

Rationale: The primary purpose of prescribing calcium acetate for a patient with CKD is to reduce phosphate levels. Calcium acetate acts as a phosphate binder, preventing the absorption of dietary phosphate in the intestines. Elevated phosphate levels in CKD can lead to complications such as mineral and bone disorders. Treating hyperkalemia (A) involves other medications like potassium binders, not calcium acetate. Lowering blood pressure (C) typically involves antihypertensive drugs. Increasing hemoglobin levels (D) is usually managed with erythropoiesis-stimulating agents in CKD patients. Therefore, option B is the correct answer for the primary purpose of prescribing calcium acetate in CKD patients.

Correct Answer: B

Rationale: The correct answer is B: Relieve bronchospasm. Tiotropium is an anticholinergic medication that acts by relaxing the muscles around the airways, thereby helping to relieve bronchospasm in patients with COPD. This results in improved airflow and reduced shortness of breath. A: Reduce mucus production - This is incorrect as tiotropium does not directly affect mucus production but rather focuses on bronchospasm relief. C: Suppress cough - Tiotropium may help with cough associated with COPD by improving airflow, but its primary purpose is not to suppress cough. D: Thin respiratory secretions - Tiotropium does not have a direct effect on thinning respiratory secretions; its main action is bronchodilation to relieve bronchospasm in COPD.

Correct Answer: B

Rationale: The correct answer is B: Weight gain. Olanzapine is known to cause metabolic side effects, including weight gain. This is important to monitor as it can lead to various health issues such as diabetes and cardiovascular problems. Hypertension (A), hypoglycemia (C), and bradycardia (D) are not commonly associated with olanzapine use, making them less likely side effects to monitor in this case.

Correct Answer: D

Rationale: The correct answer is D because central-type obesity with thin extremities is a classic characteristic of Cushing's syndrome due to excess cortisol. This pattern of weight distribution is caused by cortisol's impact on fat metabolism and distribution. A is incorrect because a husky voice and hoarseness are not typical symptoms of Cushing's syndrome. B is incorrect as warm, soft, moist, salmon-colored skin is not a common finding in Cushing's syndrome. C is incorrect because visible swelling of the neck without pain is not a typical sign of Cushing's syndrome.

Correct Answer: C

Rationale: The correct answer is C: Notify the healthcare provider if the child complains of ringing in the ears. This is important because ringing in the ears can be a sign of salicylate toxicity, a potential side effect of aspirin use in children with rheumatic fever. It is crucial to monitor for this symptom to prevent serious complications. A: Instructing the parents to hold the aspirin until the child has a tepid sponge bath is not the most important intervention. Managing salicylate toxicity takes precedence over comfort measures. B: Administering the aspirin with at least two ounces of water or juice is a general guideline for medication administration but not the most critical intervention in this scenario. D: Advising the parents to question the child about seeing yellow halos around objects is not directly related to the potential side effects of aspirin in this case. Monitoring for salicylate toxicity through symptoms like ringing in the ears is more crucial.

Correct Answer: C

Rationale: Rationale: 1. Enoxaparin is a low molecular weight heparin that primarily affects the intrinsic pathway of coagulation. 2. INR is used to monitor the effectiveness of anticoagulants affecting the intrinsic pathway. 3. Monitoring INR helps ensure the patient is within the therapeutic range to prevent clotting without excessive bleeding. 4. PT and PTT primarily evaluate the extrinsic and intrinsic pathways, respectively, not specific to enoxaparin. 5. Platelet count is not directly related to monitoring the effectiveness of enoxaparin in treating DVT.