Correct Answer: B

Rationale: Monitoring liver function tests is essential for clients taking phenytoin, an anticonvulsant that can cause hepatotoxicity, leading to elevated liver enzymes or liver damage.
Choice A is incorrect because phenytoin is not commonly associated with thrombocytopenia; blood dyscrasias are rare but possible.
Choice C is incorrect because blood urea nitrogen is not directly affected by phenytoin; it is more relevant for drugs affecting renal function.
Choice D is incorrect because phenytoin can cause hyponatremia, but it is less critical than liver function monitoring, as hepatotoxicity is a more significant risk.

Correct Answer: A

Rationale: Taking doxycycline with a full glass of water prevents esophageal irritation. Antacids reduce absorption, grapefruit juice is unrelated, and tooth discoloration is a risk in children.

Correct Answer: A

Rationale: Comparing the client's current weight with preprocedure weight is the best way to evaluate the effectiveness of the paracentesis, which is a procedure to remove excess fluid from the abdominal cavity. The fluid buildup, or ascites, is a common complication of end-stage liver disease (ESL
D), which is a condition in which the liver is severely damaged and cannot function adequately.
Choice B is wrong because examining for leakage at the site of the procedure is not a measure of effectiveness, but a potential complication that should be monitored and reported.
Choice C is wrong because checking the client's serum albumin levels is not relevant to the paracentesis. Albumin is a protein that helps maintain fluid balance in the body, but it is not affected by the removal of fluid from the abdomen.
Choice D is wrong because confirming that the client is able to urinate is not related to the paracentesis. Urination is a function of the kidneys, not the liver, and it does not reflect the amount of fluid removed from the abdomen.

Correct Answer: A

Rationale: The nurse should ensure the state health department has been notified of the child's Lyme disease, as it is a reportable disease in most states. Reporting helps to monitor the incidence and prevalence of Lyme disease and to implement prevention and control measures.
Choice B is wrong because antitoxin is not used to treat Lyme disease. Antitoxin is a substance that neutralizes the effects of a toxin, such as botulism or tetanus. Lyme disease is caused by a bacterium called Borrelia burgdorferi, which can be treated with antibiotics.
Choice C is wrong because Lyme disease is not transmitted by sharing personal belongings. Lyme disease is spread to humans by the bite of infected ticks that carry the bacterium. The risk of getting Lyme disease can be reduced by avoiding tick-infested areas, wearing protective clothing, using insect repellent, and removing ticks promptly.
Choice D is wrong because skin necrosis is not a common complication of Lyme disease. Skin necrosis is the death of skin tissue due to lack of blood supply or infection. Lyme disease can cause a characteristic skin rash called erythema migrans, which is usually circular or oval and expands over time. Other possible signs and symptoms of Lyme disease include fever, headache, fatigue, joint pain, and neurological problems.

Correct Answer: B

Rationale: Hypocalcemia is a potential complication after thyroidectomy due to accidental removal or damage to the parathyroid glands, which regulate calcium; symptoms like tetany or numbness should be monitored.
Choice A is incorrect because tachycardia is not a primary postoperative complication; it may occur with pain or hyperthyroidism but is less specific.
Choice C is incorrect because a fever of 37.5°C is not significant and may be a normal postoperative response, not a complication unless persistent.
Choice D is incorrect because increased appetite is not a typical postoperative complication; hypothyroidism may cause decreased appetite.