Correct Answer: A

Rationale: Monitoring white blood cell count is critical during chemotherapy due to immunosuppression risk. Potassium, glucose, and creatinine are less directly affected.

Correct Answer: C

Rationale: Discussing with the client his inappropriate behavior prior to seclusion is important, but it's not the most appropriate action. The priority is to ensure the safety of the client and others, which can be achieved by documenting the client's behavior prior to seclusion. Offering fluids every 2 hours is a good practice to keep the client hydrated, especially if they are agitated or physically active. However, this is not the most appropriate action in this context. Documenting the client's behavior prior to being placed in seclusion is the most appropriate action. This documentation is crucial for legal and ethical reasons, and it helps in evaluating the effectiveness of the intervention. Assessing the client's behavior once every hour is important to monitor the client's condition and response to seclusion. However, this is not the most appropriate action in this context.

Correct Answer: A

Rationale: Chest tightness is a potential adverse effect of sumatriptan, a triptan used for cluster headaches, due to its vasoconstrictive effects, which may mimic angina and require immediate evaluation.
Choice B is incorrect because weight gain is not associated with sumatriptan; it is more typical of other medications like antidepressants.
Choice C is incorrect because fever is not a common side effect unless an infection is present.
Choice D is incorrect because tachycardia, not bradycardia, may occur due to sumatriptan's stimulatory effects.

Correct Answer: A

Rationale: Decreased fetal movement is a concerning finding that may indicate fetal distress or compromise, requiring immediate reporting to the provider for further evaluation, such as a nonstress testisbn or biophysical profile.
Choice B is wrong because a blood pressure of 120/80 mm Hg is within the normal range for pregnancy and does not require reporting.
Choice C is wrong because a fundal height of 36 cm at 36 weeks is normal, as fundal height in centimeters typically corresponds to gestational age (±2 cm).
Choice D is wrong because mild ankle edema is a common, benign finding in late pregnancy due to increased fluid retention and pressure from the gravid uterus, and it does not typically require reporting unless accompanied by other symptoms like sudden swelling or signs of preeclampsia.

Correct Answer: B

Rationale: Removing contact lenses before instilling latanoprost eye drops prevents the lenses from absorbing the medication or becoming damaged, ensuring proper administration for open-angle glaucoma.
Choice A is incorrect because latanoprost is typically instilled in the evening, as it is most effective at night to reduce intraocular pressure.
Choice C is incorrect because, while iris darkening is a possible side effect, it is not guaranteed or permanent in all clients and is not the priority instruction.
Choice D is incorrect because applying pressure to the inner corner (nasolacrimal duct) of the eye, not the outer corner, prevents systemic absorption, but this is less critical than ensuring proper administration.