For a client with an exacerbation of rheumatoid arthritis, the physician prescribes the corticosteroid prednisone (Deltasone). When caring for this client, the nurse should monitor for which adverse drug reactions?

Correct Answer: A

Rationale: Corticosteroids, like prednisone, are commonly associated with several adverse drug reactions. Increased weight is often observed due to fluid retention and increased appetite caused by corticosteroids. Hypertension can result from the sodium and water retention triggered by these medications. Insomnia is a common side effect of corticosteroids due to their stimulant effect on the central nervous system. It is important for the nurse to monitor the client for these adverse reactions and report any concerning symptoms to the healthcare provider for appropriate management.

Correct Answer: C

Rationale: The question is asking about the characteristics the nurse might expect to observe in Mr. Gil. Given the information provided, Mr. Gil's possible condition can be related to a slowly progressive deficit in intellect. This might manifest as cognitive decline, memory issues, and other intellectual challenges over an extended period of time. This description aligns with conditions such as dementia or Alzheimer's disease, which are characterized by a gradual decline in cognitive abilities rather than rapid deterioration (as in option B) or transient episodes (as in option A). Therefore, option C is the most likely characteristic the nurse could expect when observing Mr. Gil.

Correct Answer: A

Rationale: The appropriate action by the nurse is to observe the patient for abnormal bleeding. Warfarin is an anticoagulant medication, and one of its serious side effects is excessive bleeding. It is important for the nurse to monitor the patient closely for signs of abnormal bleeding, such as easy bruising, blood in urine or stool, or prolonged bleeding from cuts or wounds. This observation allows for early detection and intervention if any abnormal bleeding occurs. Notifications to the healthcare provider should also be made if abnormal bleeding is suspected. It is crucial not to make any changes to the warfarin dose or administer Vitamin K without a physician's order, as these actions can have serious consequences.

Correct Answer: C

Rationale: Patients with lymphoma are at higher risk for infections because their immune system is often compromised due to the disease itself or treatment such as chemotherapy. Going outside for a walk exposes the patient to various environmental factors including pathogens, bacteria, and viruses that can increase the risk of infections. In contrast, going to church, cleaning the house, and watching television do not necessarily pose the same level of risk for infection as being outside in the open air. It is therefore important for patients with lymphoma to avoid unnecessary exposure to potential sources of infection to reduce their risk of developing infections.

Correct Answer: A

Rationale: With a WBC count of 3,000/ul (indicating leukopenia or low white blood cell count), the priority nursing intervention should be preventing infection. Leukopenia puts the client at a higher risk of developing infections due to a compromised immune system. Nurses should focus on implementing strict infection control measures, such as hand hygiene, maintaining a sterile environment, and promoting vaccination compliance to reduce the risk of infection for the hospitalized client. This intervention is crucial for ensuring the client's safety and well-being during their hospital stay. Alleviating pain, controlling infection, and monitoring blood transfusion reactions are important aspects of care but in this scenario, preventing infection takes precedence due to the client's low WBC count.