Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?

Correct Answer: A

Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.

Correct Answer: A

Rationale: In this scenario, option A is the correct answer that indicates a need for further instruction. The rationale behind this is that clients receiving immunosuppressive therapy, such as cyclosporine after a kidney transplant, should avoid live vaccines like the influenza vaccine to prevent potential complications due to decreased immune response. Option B, having dental checkups every 3 months, is important because immunosuppressed individuals are at a higher risk of oral infections. Option C, self-monitoring blood pressure at home, is crucial as hypertension is a common side effect of cyclosporine therapy. Option D, calling the healthcare provider for changes in urine volume or appearance, is also vital as it could indicate kidney complications which need immediate attention. Educationally, understanding the intricacies of medication regimens post-transplant is crucial for patient safety and optimal outcomes. Emphasizing the rationale behind each instruction can help clients make informed decisions about their healthcare and adhere to their treatment plan effectively.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer that indicates a need for further instruction. Azathioprine (Imuran) is an immunosuppressant medication commonly used in transplant recipients to prevent organ rejection. It is not a medication that should be discontinued abruptly after 14 days. The client needs to understand that azathioprine is typically taken long-term to maintain the transplant's success. Option A is correct because transplant recipients are at increased risk of infections due to their suppressed immune system, so monitoring for signs of infection is crucial. Option C is incorrect because azathioprine is usually taken on an empty stomach to maximize absorption. Taking it with meals may decrease its effectiveness. Option D is incorrect as missing a dose of azathioprine should not be ignored. The client should be instructed to take the missed dose as soon as they remember, but if it is close to the next scheduled dose, they should skip the missed dose and not double up. Educationally, this question highlights the importance of patient education in medication management, especially for clients with complex medication regimens like transplant recipients. Understanding the rationale behind medication instructions is crucial for ensuring treatment efficacy and patient safety.

Correct Answer: C

Rationale: In administering the MMR vaccine to a child, the correct approach is to administer it subcutaneously in the outer aspect of the upper arm. This method is chosen for several reasons. Firstly, the subcutaneous route is preferred for vaccines that are less irritating and have fewer side effects, which is the case for the MMR vaccine. Administering the vaccine in the outer aspect of the upper arm allows for easier access, especially in children, and reduces the risk of injury to underlying structures. The other options provided are incorrect for various reasons. Administering the vaccine intramuscularly in the deltoid muscle (option A) may not be ideal for children due to the smaller muscle mass in that area. Subcutaneous administration in the gluteal muscle (option B) may not be recommended for vaccines in children as it can be more painful and has a risk of hitting the sciatic nerve. Intramuscular administration in the anterolateral aspect of the thigh (option D) is typically used for infants and toddlers, not older children who can receive the vaccine in the upper arm more comfortably. In an educational context, understanding the rationale behind the route of administration for vaccines is crucial for healthcare providers to ensure safe and effective delivery of vaccinations, especially in pediatric populations. Proper administration techniques help minimize discomfort, reduce the risk of adverse reactions, and ensure the vaccine's efficacy, ultimately contributing to successful immunization programs and public health outcomes.