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: 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: Gingival hyperplasia. Phenytoin is known to cause gingival overgrowth as a side effect. This is due to its effect on fibroblasts in the gums, leading to increased connective tissue production. Hypotension (A), bradycardia (C), and hyperkalemia (D) are not common side effects of phenytoin. Monitoring for gingival hyperplasia is crucial to prevent complications such as difficulty in eating, speaking, and maintaining oral hygiene.

Correct Answer: C

Rationale: Rationale: C is the correct answer. Ranitidine is usually taken on an empty stomach to maximize its effectiveness in reducing stomach acid production. Therefore, taking it with meals would decrease its efficacy. A, B, and D are incorrect because taking ranitidine at bedtime is common practice, smoking can worsen ulcer symptoms, and ranitidine does indeed reduce stomach acid.

Correct Answer: B

Rationale: The correct answer is B because it violates patient confidentiality. Reading a client's history and physical in a public area breaches the client's privacy rights. The other choices do not directly compromise patient confidentiality. A involves discussing a cure for AIDS, which is not a breach of confidentiality. C involves sharing personal experiences with the client, and D involves discussing a client's history of drug abuse in a visitor's lounge, which may not be overheard by the client or staff directly involved in the client's care.

Correct Answer: B

Rationale: The primary purpose of prescribing montelukast for a patient with asthma is to prevent asthma attacks. Montelukast is a leukotriene receptor antagonist that helps to reduce inflammation in the airways, thereby preventing asthma symptoms and attacks. It is not used to relieve acute bronchospasm (Choice A), as it is not a fast-acting rescue medication like a bronchodilator. Montelukast also does not thin respiratory secretions (Choice C) or suppress cough (Choice D) as its main mechanism of action is to prevent and control asthma symptoms by inhibiting leukotrienes.

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: B

Rationale: The correct answer is B: Report any weight gain of more than 2 pounds in a day. This instruction is crucial for a client with heart failure taking furosemide as sudden weight gain can indicate fluid retention, which can worsen heart failure. Monitoring weight daily can help detect early signs of fluid overload. A: Taking the medication before bedtime is not a critical instruction for furosemide as it is usually taken in the morning to prevent nocturia. C: Increasing intake of high-sodium foods contradicts the purpose of furosemide, which is a diuretic used to reduce fluid retention by promoting diuresis. D: Limiting fluid intake to less than 1 liter per day can lead to dehydration and electrolyte imbalances, which can be harmful for a client with heart failure.

Correct Answer: A

Rationale: The correct answer is A: Hyperkalemia. Lisinopril is an ACE inhibitor that can cause potassium retention, leading to hyperkalemia. Monitoring potassium levels is crucial to prevent serious complications like cardiac arrhythmias. Hypoglycemia (B) is not a common side effect of lisinopril. Bradycardia (C) and constipation (D) are also not typically associated with lisinopril use. Hyperkalemia is the most critical side effect to monitor in this case.