Which of the following is the priority nursing diagnosis for a client undergoing chemotherapy?

Correct Answer: A

Rationale: Altered nutrition is often the priority nursing diagnosis for clients undergoing chemotherapy because the treatment can cause side effects such as nausea, vomiting, anorexia, and mucositis, leading to malnutrition and weight loss. Proper nutrition is essential for maintaining strength, supporting the immune system, and promoting recovery. While fear, anxiety, and decreased cardiac output are valid concerns, addressing nutritional deficits is critical to the client's overall well-being and ability to tolerate treatment.

Correct Answer: C

Rationale: Nystatin is an antifungal medication used to treat fungal infections, such as candidiasis. Before administration, assessing whether the client could be pregnant is critical because nystatin's safety in pregnancy is not fully established (Category C), meaning potential risks to the fetus cannot be ruled out without further evaluation. This makes pregnancy status a key safety consideration to prevent harm to an unborn child, outweighing other factors in urgency. The type of diet or amount of fat might influence general health or drug absorption minimally but isn't directly critical to nystatin's administration. Height and weight could affect dosing in some medications, but nystatin's dosing is typically standard and not weight-based for most fungal infections. Thus, confirming pregnancy status ensures the drug's safety profile aligns with the client's condition, making choice C the most critical assessment data to review prior to administration.

Correct Answer: C

Rationale: The statement "I'll have my physician lower my dosage once I start to feel okay" indicates an understanding of the treatment regimen because it shows that the client recognizes the need to continue the medication as prescribed and not discontinue it abruptly. It highlights that the client intends to follow up with their physician for appropriate adjustments to the dosage as needed. This demonstrates a responsible approach to managing their alcohol withdrawal with diazepam (Valium).

Correct Answer: A

Rationale: Digitalis (e.g., Digoxin) and hydrochlorothiazide can cause a severe interaction because hydrochlorothiazide can reduce potassium levels in the body. Low potassium levels (hypokalemia) can increase the risk of digitalis toxicity, leading to dangerous effects on the heart. Therefore, patients taking hydrochlorothiazide along with digitalis need close monitoring of their potassium levels and potential adjustments to their digitalis therapy. It is important to communicate this risk to the healthcare team to ensure patient safety.

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.