Correct Answer: A

Rationale: Monitoring for signs of bone marrow suppression (e.g., bruising, fever, infection) is critical with carbamazepine, an anticonvulsant, as it can cause serious hematologic side effects like agranulocytosis or aplastic anemia in trigeminal neuralgia treatment.
Choice B is incorrect because carbamazepine can be taken with or without food; a high-fat meal is not necessary.
Choice C is incorrect because carbamazepine takes days to weeks to relieve pain, not immediately.
Choice D is incorrect because carbamazepine should not be discontinued abruptly, even if pain resolves, to avoid withdrawal or seizure risk; it requires provider guidance.

Correct Answer: A

Rationale: Rinsing the mouth after using ipratropium, an anticholinergic inhaler, prevents dry mouth and reduces the risk of oral candidiasis, a potential side effect.
Choice B is incorrect because ipratropium provides gradual bronchodilation and does not offer immediate relief; short-acting beta-agonists like albuterol are used for acute symptoms.
Choice C is incorrect because ipratropium is typically used 3-4 times daily, not every 2 hours as needed; overuse can cause side effects like tachycardia.
Choice D is incorrect because a spacer can be used with ipratropium to improve medication delivery, especially for clients with poor inhaler technique.

Correct Answer: B

Rationale: Reporting signs of hyperkalemia is critical with spironolactone due to potassium-sparing effects. Potassium intake should not increase, it's taken in the morning, and diuresis is not immediate.

Correct Answer: A

Rationale: A heart rate of 56/min is below the normal range (60-100/min) and may indicate digoxin toxicity, especially in heart failure clients, as digoxin slows the heart rate by enhancing vagal tone; this requires immediate reporting to the provider.
Choice B is wrong because a blood pressure of 140/90 mm Hg, while elevated, is not directly related to digoxin toxicity and should be monitored but is not the priority.
Choice C is wrong because a weight gain of 0.5 kg in 24 hours is not significant enough to indicate fluid overload in heart failure; a gain of >1 kg (2.2 lb) in 24 hours would be more concerning.
Choice D is wrong because a potassium level of 4.2 mEq/L is within the normal range (3.5-5.0 mEq/L), and while hypokalemia increases digoxin toxicity risk, this level is not concerning.

Correct Answer: B,C,D

Rationale: The findings that require immediate follow-up are: Adult child accompanying parent reports decline in client, expressing concern over memory and thought process, appetite, and self-care. Adult child states. “My sibling and I hired help at home for my parent. We thought that would help but it has not. I found the title to the car today, signed over to me.” Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression. Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 lb in the past month. Client says. 'Why don't you just leave me? I am of no use.' These findings suggest that the client may have cognitive impairment, depression, and/or malnutrition, which can affect their health and quality of life. The nurse should perform a comprehensive assessment of the client's cognitive, behavioral, and functional status, review their medications and possible side effects, provide education and support for healthy aging, and collaborate with interdisciplinary teams and community resources. The nurse should also evaluate the client's home environment and lifestyle, and consider nonpharmacological approaches to manage behavioral problems. The nurse should also monitor the client's vital signs and weight regularly.