Correct Answer: C

Rationale: The correct action for the nurse to take first is to assess the client for adverse reactions (
Choice
C). This is crucial because the nurse needs to ensure the client's safety and well-being after missing the medication dose. By assessing the client for any potential adverse reactions promptly, the nurse can address any immediate concerns and take necessary actions to mitigate any negative effects. This step prioritizes the client's health and safety.

Other choices are not the first priority in this situation:
A: Filing an incident report (
Choice
A) can be done later after ensuring the client's immediate safety.
B: Determining factors that led to the omission (
Choice
B) is important for preventing future errors but is not the first step when a client's health may be at risk.
D: Reporting the missed dosage to the client's provider (
Choice
D) is important but should come after assessing the client's current condition.

Correct Answer: C

Rationale: The correct answer is C: Administer the medication through a straw. This is to prevent the discoloration of the teeth that can occur when iron supplements come in contact with teeth. Using a straw helps direct the medication to the back of the throat, bypassing the teeth. Diluting with milk (
A) can reduce absorption, caffeinated beverages (
B) can interfere with iron absorption, and antacids (
D) can decrease the effectiveness of iron supplements.

Correct Answer: B

Rationale: The correct answer is B: Hypotension. Allergic reactions to ceftriaxone can manifest as hypotension due to vasodilation from histamine release. Polyuria, nausea, and bradycardia are not typical manifestations of allergic reactions to ceftriaxone. Polyuria may indicate kidney issues, nausea can be a common side effect, and bradycardia is not commonly associated with allergic reactions. It's important for the nurse to recognize hypotension as a potential allergic reaction to ceftriaxone to provide prompt and appropriate intervention.

Correct Answer: A

Rationale: The correct answer is A: Discard the vial of medication if the solution is cloudy. This is important because epoetin alfa should be clear and colorless. Cloudiness may indicate contamination or degradation, rendering it unsafe for administration. Discarding the cloudy solution ensures that the client receives the appropriate and effective medication.

Choice B: Shaking the vial may introduce air bubbles and compromise the integrity of the medication.

Choice C: Diluting the medication with sterile water is not recommended without specific instructions as it may alter the concentration and effectiveness.

Choice D: Thawing the medication in the vial is incorrect as epoetin alfa is not typically frozen and does not require thawing before administration.

Correct Answer: A

Rationale: Rationale for Correct Answer (
A): Pioglitazone, a thiazolidinedione, can lead to fluid retention as a common adverse effect due to its mechanism of action on the kidneys. This can manifest as weight gain, edema, or worsening heart failure. Monitoring for signs of fluid overload is crucial.
Summary of Incorrect

Choices:
B: Tinnitus is not a known adverse effect of pioglitazone.
C: Insomnia is not typically associated with pioglitazone use.
D: Orthostatic hypotension is not a common side effect of pioglitazone.