A nurse is caring for a client who consumed alcohol 2 days after taking disulfiram. The nurse should monitor the client for which of the following findings?
Constipation
Dry skin
Hypotension
Urinary retention
The Correct Answer is C
Choice A reason: Constipation isn’t a primary effect of disulfiram-alcohol reaction, which causes acetaldehyde buildup, triggering vasodilation and nausea, not gut motility issues. Scientifically, this reaction targets cardiovascular and systemic responses, lacking evidence for significant gastrointestinal stasis as a monitored outcome in this scenario.
Choice B reason: Dry skin isn’t linked to disulfiram-alcohol interaction, which induces flushing and sweating from acetaldehyde toxicity, not dehydration. Scientifically, the reaction affects vascular and autonomic systems, producing moist, not dry, skin responses, making this an unrelated finding for monitoring here.
Choice C reason: Hypotension occurs in disulfiram-alcohol reaction as acetaldehyde dilates vessels, dropping blood pressure. This cardiovascular effect, alongside tachycardia, is a key sign to monitor, aligning with scientific understanding of the drug’s inhibition of aldehyde dehydrogenase, causing systemic distress.
Choice D reason: Urinary retention isn’t a typical disulfiram-alcohol effect; the reaction focuses on vasodilation, nausea, and hypotension from acetaldehyde. Scientifically, autonomic overstimulation may occur, but bladder dysfunction isn’t a primary outcome, making this less critical to monitor than cardiovascular collapse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Budesonide prevents, not rescues, asthma attacks; rescue inhalers like albuterol are used instead. This shows misunderstanding of its controller role in management.
Choice B reason: Rinsing after budesonide, a corticosteroid, prevents oral thrush by removing residue. This reflects correct understanding of side effect prevention in asthma therapy.
Choice C reason: Timing budesonide to meals and bedtime isn’t standard; it’s typically twice daily. This indicates confusion about its preventive, not situational, use.
Choice D reason: Pre-exercise use fits rescue inhalers, not budesonide, which builds long-term control. This misapplies its purpose, showing a lack of asthma management grasp.
Correct Answer is B
Explanation
Choice A reason: Bathing under running water risks temperature instability and drowning in newborns. This is unsafe, showing a lack of proper care understanding.
Choice B reason: Washing the face with a warm, wet washcloth without soap protects delicate skin, avoiding irritation. This aligns with newborn hygiene best practices.
Choice C reason: Moist towelettes often contain chemicals, unsuitable for newborn scalps. Warm water and cloth are gentler, so this reflects misunderstanding of care.
Choice D reason: Daily baths dry out newborn skin, increasing irritation risk. Spot cleaning is advised, making this an incorrect application of hygiene teaching.
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