A nurse in an acute care facility is collecting data from a client who has received the meningococcal conjugate vaccine.
The nurse should monitor the client for which of the following findings as an adverse effect of the vaccine?

Choice A rationale:

Donepezil does not decrease urinary output. It works by increasing the amount of a certain naturally occurring substance in the brain.

Choice B rationale:

Donepezil does not improve pulmonary function. Its primary function is to improve mental function.

Choice C rationale:

Donepezil improves cognitive function. It can improve thinking ability and slow the loss of these abilities in people who have Alzheimer’s disease.

Choice D rationale:

Donepezil does not decrease the incidence of seizures. In fact, patients should inform their healthcare provider if they have a history of seizures before starting donepezil.

Choice A rationale:

A negative mammogram is not a requirement of the iPLEDGE program. Mammograms are used to screen for breast cancer and are not related to isotretinoin therapy.

Choice B rationale:

Regular Papanicolaou tests, which screen for cervical cancer, are not a requirement of the iPLEDGE program. These tests are not related to isotretinoin therapy.

Choice C rationale:

There is no requirement for clients to begin a daily supplement of vitamin A prior to initiating therapy. In fact, taking additional vitamin A while on isotretinoin can increase the risk of vitamin A toxicity.

Choice D rationale:

Sexually active female clients must use two forms of birth control during treatment. This is because isotretinoin can cause severe birth defects.