A patient with bipolar disorder is prescribed valproic acid. What is an important side effect for the nurse to monitor?

Correct Answer: B

Rationale: Correct Answer: B (Liver toxicity) Rationale: 1. Valproic acid is known to cause liver toxicity. 2. The nurse should monitor liver function tests regularly. 3. Signs of liver toxicity include jaundice, abdominal pain, and nausea. 4. Prompt detection is crucial to prevent serious complications. Summary: A: Hypertension - Not a common side effect of valproic acid. C: Hyperglycemia - More commonly associated with other medications like antipsychotics. D: Bradycardia - Not a typical side effect of valproic acid.

Correct Answer: C

Rationale: The primary action of digoxin in heart failure is to strengthen cardiac contractions. Digoxin inhibits the sodium-potassium pump, leading to an increase in intracellular calcium levels, which enhances the force of myocardial contractions. This helps improve cardiac output and symptoms of heart failure. Explanation: A: Incorrect - Digoxin does not increase heart rate, it mainly affects the strength of contractions. B: Incorrect - Digoxin does not decrease cardiac output; it actually helps improve it by enhancing contractility. D: Incorrect - Digoxin may have a slight effect on lowering blood pressure, but its primary action in heart failure is to strengthen cardiac contractions, not lower blood pressure.

Correct Answer: D

Rationale: The correct answer is D: Reduce anxiety. Alprazolam is a benzodiazepine that acts on the central nervous system to enhance the effects of a neurotransmitter called GABA, which helps to calm the brain and reduce anxiety. This medication does not increase energy levels (choice A), induce sedation (choice B), or elevate mood (choice C). Alprazolam's primary action is to target and alleviate the symptoms of anxiety by promoting relaxation and reducing excessive brain activity associated with anxiety disorders.

Correct Answer: C

Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.

Correct Answer: A

Rationale: The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, causing side effects. Supplementing with folic acid can help manage these side effects. It is crucial for the nurse to emphasize the importance of taking folic acid as prescribed to prevent adverse effects. Summary of Incorrect Choices: B: Avoid alcohol completely - While alcohol should be limited or avoided due to potential liver toxicity with methotrexate, complete avoidance may not be necessary for all patients. C: Expect to see immediate results - Methotrexate takes time to work, and patients should not expect immediate results. Patience is necessary. D: Limit fluid intake to 1 liter per day - There is no specific guideline to limit fluid intake with methotrexate. Adequate hydration is important for overall health.