A nurse is caring for a client who recently started alteplase therapy. The nurse should monitor the client for which of the following adverse effects?

Correct Answer: B

Rationale: The correct answer is B: Headache. Alteplase is a thrombolytic medication that can cause cerebral bleeding, leading to headaches. Monitoring for headaches is crucial as it can indicate a serious adverse effect. Bronchodilation (A) is not associated with alteplase therapy. Edema (C) is not a common adverse effect of alteplase. Hypertension (D) is a potential adverse effect, but it is not as specific or common as headaches in this context.

Correct Answer: B

Rationale: Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Patients with peptic ulcer disease are at a higher risk of gastrointestinal bleeding, so clopidogrel is contraindicated. Myocardial infarction, pancreatitis, and myasthenia gravis are not contraindications for clopidogrel use.

Correct Answer: B

Rationale: The correct answer is B: Reticulocyte count. Reticulocytes are immature red blood cells, and monitoring their count can help determine the effectiveness of folic acid in treating megaloblastic anemia. Increased reticulocyte count indicates improved production of red blood cells. Amylase level, C-reactive protein, and creatinine clearance are not directly related to monitoring the effectiveness of folic acid in treating megaloblastic anemia.

Correct Answer: A

Rationale: The correct answer is A: Rapid pulse. When a client is undergoing anticoagulant therapy with heparin, the nurse should monitor for signs of hemorrhage. A rapid pulse can indicate internal bleeding, a common complication of anticoagulant therapy. Other choices such as B: Yellowing of the sclera, C: Elevated blood pressure, and D: Pale-colored stools are not typically associated with hemorrhage. Yellowing of the sclera may indicate jaundice, elevated blood pressure may be related to other conditions, and pale-colored stools may indicate liver or gallbladder issues. Rapid pulse is the most pertinent finding related to hemorrhage in this context.

Correct Answer: C

Rationale: The correct answer is C: Part of general pancytopenia. Secondary neutropenia in adults can occur as part of general pancytopenia, where there is a decrease in all blood cell types. This can be caused by various conditions such as infections, medications, autoimmune disorders, and bone marrow disorders. Rationale: A: Congenital is incorrect because congenital neutropenia refers to a condition present at birth, not secondary neutropenia. B: Anti-hypertensive drugs may cause drug-induced neutropenia, but it is not the primary cause of secondary neutropenia in adults. D: Familial neutropenia is a genetic disorder that runs in families and is not a common cause of secondary neutropenia in adults.