An adult patient has presented to the health clinic with a complaint of a firm, painless cervical lymph node. The patient denies any recent infectious diseases. What is the nurse's most appropriate response to the patient's complaint?

Correct Answer: B

Rationale: The correct answer is B: Promptly refer the patient for medical assessment. A firm, painless cervical lymph node in an adult without recent infectious diseases raises concerns for potential underlying serious conditions such as malignancy. Referring the patient for medical assessment allows for further evaluation, including physical examination, laboratory tests, and imaging studies if necessary, to determine the cause of the lymphadenopathy. This prompt referral is crucial for timely diagnosis and appropriate management. Summary: A: Calling 911 is not warranted as the patient is stable and does not have an emergency medical condition. C: Facilitating a radiograph may not provide sufficient information for evaluating the lymph node and delays definitive assessment. D: Encouraging the patient to wait and track the lymph node size can lead to delayed diagnosis and potentially worsening of the underlying condition.

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: The correct answer is B: Aminocaproic acid. This drug is a fibrinolytic inhibitor that can be used to manage bleeding complications associated with alteplase therapy. It helps to prevent excessive bleeding by inhibiting the breakdown of blood clots. Having aminocaproic acid available is crucial in case the client experiences severe bleeding as a result of alteplase therapy. A: Vitamin K is used to reverse the effects of warfarin, a blood thinner, and is not indicated for managing bleeding due to alteplase therapy. C: Protamine is used to reverse the effects of heparin, not alteplase, and is not indicated for managing bleeding due to alteplase therapy. D: Deferoxamine is an antidote for iron poisoning and is not indicated for managing bleeding due to alteplase therapy. In summary, aminocaproic acid is the correct choice as it helps manage bleeding complications associated with alteplase therapy

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.