A patient has taken two doses of interferon Alfa-2b (Intron-A). He comes to the clinic today with the following complaints. Which symptoms would the nurse identify as common adverse effects of this therapy?

Correct Answer: A

Rationale: Interferon Alfa-2b, used for hepatitis or cancer, commonly causes flu-like symptoms—dizziness , fatigue , and anorexia —due to its immune-modulating effects. Dizziness reflects CNS impact, often early in therapy, while fatigue and appetite loss stem from systemic inflammation. An itchy rash might suggest hypersensitivity but is less frequent than these systemic effects. The nurse identifies dizziness as a common adverse effect (correct answers: 1, 3, 4), distinguishing it from severe reactions requiring intervention. This aligns with interferon's side effect profile, where patients often report such symptoms within days of starting, necessitating education on management (e.g., rest, hydration). Choice A is a key identifier among expected effects, ensuring appropriate monitoring.

Correct Answer: B

Rationale: Pentamidine (Pentam) is a medication used for the treatment and prevention of Pneumocystis carinii pneumonia (PCP) in immunocompromised patients, such as those with HIV/AIDS. A known side effect of pentamidine therapy is ocular toxicity, including retinal damage. The nurse must closely monitor the client for signs and symptoms of retinal toxicity, such as changes in vision, eye pain, or sensitivity to light. Regular ophthalmologic evaluations may also be necessary to detect any ocular complications early and prevent permanent damage. Hence, observing for signs of retinal damage is crucial while the client is on pentamidine infusion therapy.

Correct Answer: C

Rationale: Oxymetazoline treats nasal congestion in allergic rhinitis by acting as an α-adrenergic agonist. Option , increased nasal blood flow, is incorrect-vasoconstriction reduces flow. Option , increased arterial pressure, doesn't directly relieve congestion. Option , receptor stimulation on nasal vasculature, is correct-oxymetazoline stimulates α-receptors, causing vasoconstriction, shrinking swollen mucosa, and improving airflow. Option , transmembrane conductance change, is unrelated to its action. Option (E), understimulation, contradicts its agonist role. This vasoconstrictive effect rapidly alleviates congestion, explaining the symptom improvement. Unlike antihistamines or steroids, oxymetazoline targets vascular tone, not inflammation or histamine, making it ideal for quick relief in rhinitis. Prolonged use risks rebound congestion, but the question focuses on initial efficacy, where receptor-mediated vasoconstriction is key.

Correct Answer: A

Rationale: The correct statement by the nurse is to instruct the patient to "stop taking the diuretic for a few days, and then restart it when you feel better." This is because the patient has been experiencing vomiting due to influenza, which can cause dehydration. Continuing the diuretic while experiencing such significant fluid loss can lead to further dehydration and electrolyte imbalances. It is important for the patient to pause the diuretic temporarily to allow the body to recover and then resume once the vomiting has subsided and hydration has improved. It's always best for patients to follow specific instructions given by healthcare providers in such situations.

Correct Answer: B

Rationale: A persistent dry cough is a well-known adverse effect associated with the use of angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II, thereby causing vasodilation and reducing blood pressure. However, they can also inhibit the breakdown of bradykinin, leading to the accumulation of bradykinin in the lungs. This accumulation can irritate the airways, resulting in a dry, persistent cough in some patients. It is important for healthcare providers to be aware of this side effect, as it can significantly impact a patient's quality of life and may require alternative antihypertensive medication.