Following surgery, a client is placed on cefotaxime (Claforan). The assessment for possible adverse effects should include observing for

Correct Answer: A

Rationale: Cefotaxime, a third-generation cephalosporin, treats postoperative infections but disrupts gut flora, commonly causing diarrhea due to overgrowth of pathogens like Clostridioides difficile. This adverse effect can range from mild to life-threatening pseudomembranous colitis, making it a priority observation. Headache might occur but is less frequent and specific to cefotaxime. Constipation contrasts with its GI effects, as diarrhea is more typical, while tachycardia could signal anaphylaxis or secondary infection but isn't a primary concern. Monitoring for diarrhea allows early detection of complications, enabling prompt intervention like discontinuing the drug or starting probiotics. This focus aligns with cephalosporins' pharmacological profile, where GI disturbance is a well-documented risk, especially post-surgery when patients are vulnerable. Thus, observing for diarrhea is the nurse's key assessment, ensuring patient safety and effective management of adverse effects, making A the correct choice.

Correct Answer: A

Rationale: Cortisol is indeed the primary human glucocorticoid, a true statement regulating metabolism and stress. Normal cortisol secretion is ~10-20 mg/day, not 100 mg, so that's false. ACTH suppression occurs rapidly (hours), true. Cortisol absence heightens catecholamine sensitivity, true, as in Addison's disease. Leukocyte/macrophage inhibition is a glucocorticoid action, not its absence. Cortisol's role as the major glucocorticoid underpins its therapeutic mimicry (e.g., hydrocortisone) in adrenal insufficiency.

Correct Answer: C

Rationale: Phenytoin is an anti-seizure medication commonly used to treat and prevent seizures in individuals with epilepsy. The desired outcome of taking Phenytoin is to decrease or completely stop seizures without causing excessive sedation. It works by stabilizing electrical activity in the brain to prevent abnormal firing of neurons that can lead to seizures. Therefore, the main goal of using Phenytoin is to control seizure activity and improve the quality of life for individuals with epilepsy.

Correct Answer: A

Rationale: The patient's symptoms-runny nose and itchy eyes during spring-suggest seasonal allergic rhinitis, where histamine is the main chemical mediator released from mast cells. Cromolyn sodium stabilizes mast cells, preventing histamine release, making it a prophylactic agent ideal for this scenario. Diphenhydramine is an H1 antihistamine that blocks histamine receptors after release, not preventing its release, so it's incorrect. Ranitidine is an H2 blocker, affecting gastric acid secretion, not allergic histamine pathways. Loratadine is another H1 antihistamine, also acting post-release. Theophylline (E) is a bronchodilator, irrelevant here. The question emphasizes preventing release, not blocking effects, so Cromolyn sodium stands out. Its mechanism directly addresses the root cause by stabilizing mast cells before allergen exposure triggers histamine release, offering a preventative rather than symptomatic approach, which aligns with the patient's recurring seasonal issue.

Correct Answer: A

Rationale: Enalapril, an ACE inhibitor, causes dry cough via bradykinin buildup, a common effect needing reporting to consider switching (e.g., to an ARB). Fatigue , headache , and nausea are less specific or urgent. Cough aligns with enalapril's pharmacology, critical in hypertension where adherence hinges on tolerability, making A the key side effect to report.