What should you monitor when administering Clopidogrel to a patient?

Correct Answer: D

Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.

Correct Answer: D

Rationale: Oxygen is the most important initial intervention for a patient with a low pulse oximeter reading (85%) to correct hypoxia and prevent further complications. While epinephrine (A) and albuterol (C) are used to treat asthma, oxygen is the priority to address the immediate hypoxia. Sodium bicarbonate (B) is not indicated unless there is severe metabolic acidosis.

Correct Answer: D

Rationale: Nausea and loss of appetite are common early signs of digoxin toxicity, indicating an adverse effect of the medication. These symptoms should be reported to the healthcare provider immediately for further evaluation and management.

Correct Answer: B

Rationale: Ibutilide (Corvert) is a class III antiarrhythmic medication primarily used for the treatment of atrial fibrillation and atrial flutter. It works by prolonging the action potential duration and refractory period of atrial tissue. Therefore, when a nurse notes that a patient will be taking ibutilide, it indicates that the patient likely has atrial fibrillation, a common arrhythmia characterized by rapid, irregular electrical activity in the atria of the heart.

Correct Answer: B

Rationale: Clients prescribed verapamil should be advised to avoid grapefruit juice as it can potentiate the drug's effects, leading to adverse reactions. Grapefruit juice can inhibit the metabolism of verapamil, resulting in higher blood levels of the medication and an increased risk of side effects. Instructions such as taking the medication with a full glass of water (Choice A) are not specific to verapamil and are generally recommended. While monitoring blood pressure regularly (Choice C) is important for clients on antihypertensive medications, it is not a direct concern related to verapamil. Monitoring heart rate daily (Choice D) is not a primary consideration when starting verapamil, as it is more commonly used for its effects on blood pressure and arrhythmias rather than heart rate.

Correct Answer: B

Rationale: The correct action for the nurse to take when a client on methotrexate reports bleeding gums is to check the client's current platelet count. Bleeding gums may indicate thrombocytopenia, a decreased platelet count which can be a severe side effect of methotrexate therapy. Monitoring the platelet count is crucial for early detection and management of this potentially life-threatening complication. Choice A is incorrect as bleeding gums in this context may not be an expected adverse effect of methotrexate. Choice C is irrelevant and does not address the potential underlying issue of thrombocytopenia. Choice D is not the primary action needed at this point; checking the platelet count is more urgent to assess the severity of the situation.

Correct Answer: A

Rationale: The therapeutic serum range for phenobarbital (luminal) in the treatment of anxiety is typically 5-10 mcg/ml. This range is considered effective in managing anxiety symptoms while minimizing the risk of side effects associated with higher levels of the medication. Lower serum levels may be ineffective in treating anxiety, while higher levels increase the risk of adverse effects. Therefore, maintaining the serum concentration within the range of 5-10 mcg/ml is optimal for therapeutic benefits with minimal risks.

Correct Answer: D

Rationale: It is important to educate a patient that Regular Insulin should be injected subcutaneously to ensure proper absorption of the medication. Injecting the insulin into the subcutaneous tissue allows for a slower and more consistent absorption of the medication, which helps in controlling blood glucose levels effectively. Administering insulin subcutaneously also minimizes the risk of complications associated with other injection sites or techniques.

Correct Answer: C

Rationale: When a nurse detects a hematoma at the IV catheter insertion site, applying warm compresses is beneficial as it can promote healing by enhancing circulation and reducing swelling. Elevating the client's arm helps in reducing edema, which can relieve pressure, pain, and further bleeding in the hematoma area. Stopping the infusion may be necessary in certain situations, but it is not a standard action for all hematoma cases. Applying alcohol to the insertion site is discouraged as it can cause irritation and may not aid in resolving the hematoma.