A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir).

The nurse should monitor the client for which of the following adverse effects?

Pancreatitis

Lactic acidosis

Hypothyroidism

Nephrotoxicity

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Lactic acidosis.

Lamivudine (Epivir) is a nucleoside reverse transcriptase inhibitor (NRTI) used to treat chronic hepatitis B infection and HIV infection.

One of the rare but serious adverse effects of lamivudine is lactic acidosis, which is a condition where the blood becomes too acidic due to the accumulation of lactate. Lactic acidosis can cause symptoms such as nausea, vomiting, abdominal pain, muscle weakness, rapid breathing, and low blood pressure.

Choice A is wrong because pancreatitis is not a common side effect of lamivudine.

Pancreatitis is an inflammation of the pancreas that can cause severe abdominal pain, nausea, vomiting, and fever. Pancreatitis is more likely to occur with other NRTIs such as didanosine (Videx) or stavudine (Zerit).

Choice C is wrong because hypothyroidism is not a common side effect of lamivudine.

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels of the body.

Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression.

Hypothyroidism is more likely to occur with other drugs that interfere with thyroid function such as amiodarone (Cordarone) or lithium

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Correct Answer is A

Explanation

The correct answer is choice A. Bulging fontanelle.

A bulging fontanelle is a sign of increased intracranial pressure, which can be caused by intracranial hemorrhage.

Late-onset VKDB is a condition that occurs in infants who have low levels of vitamin K, which is essential for blood clotting.Most cases of late-onset VKDB present with intracranial hemorrhage.

Choice B. Sunken eyes is wrong because it is a sign of dehydration, not intracranial hemorrhage.

Choice C. Mottled skin is wrong because it is a sign of poor circulation or shock, not intracranial hemorrhage.

Choice D. Flaring nostrils is wrong because it is a sign of respiratory distress, not intracranial hemorrhage.

Normal ranges for vitamin K plasma concentrations are 0.2 to 3.2 ng/mL for adults and 0.15 to 1.5 ng/mL for infants.

A. Obtain informed consent from the mother before giving the vaccine B. Give the vaccine intramuscularly in the anterolateral thigh C. Administer hepatitis B immune globulin (HBIG) along with the vaccine D. Delay giving the vaccine until after breastfeeding is established

Correct Answer is B

Explanation

The correct answer is choice B. Give the vaccine intramuscularly in the anterolateral thigh.

This is because the anterolateral thigh is the recommended site for intramuscular injections in infants less than 12 months of age.

It has a large muscle mass and minimal risk of injury to nerves or blood vessels.

Choice A is wrong because informed consent is not required for routine immunizations, unless the parent or guardian requests more information or declines the vaccine.

Choice C is wrong because hepatitis B immune globulin (HBIG) is only indicated for newborns whose mothers are hepatitis B surface antigen positive (HBsAg+), as they have a high risk of acquiring the infection from their mothers.

Choice D is wrong because there is no need to delay giving the vaccine until after breastfeeding is established.

Breastfeeding does not interfere with the vaccine’s effectiveness or safety, and it does not increase the risk of adverse reactions.

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A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir). The nurse should monitor the client for which of the following adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a newborn who has late-onset VKDB due to exclusive breastfeeding and inadequate oral vitamin K supplementation. Which of the following findings should indicate a possible intracranial hemorrhage to the nurse?

Correct Answer is A

Explanation

A nurse is preparing to administer hepatitis B vaccine to a newborn whose mother is hepatitis B surface antigen negative (HBsAg-). Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is caring for a newborn who has received erythromycin eye ointment as prophylaxis for ophthalmia neonatorum. What should the nurse monitor for as a potential adverse reaction to this medication?

A nurse is educating a group of college students about hepatitis B virus (HBV) transmission and prevention. The nurse should emphasize that the most common modes of transmission are which of the following? (Select all that apply)

A nurse is performing an initial assessment of a newborn who was delivered vaginally at term with no complications. Which of the following findings should alert the nurse to a potential problem?

A nurse is reviewing laboratory results for a newborn who received vitamin K injection at birth. Which of the following coagulation factors should be activated by vitamin K?

A nurse is administering erythromycin eye ointment to a newborn who has a history of allergic reaction to penicillin. What should the nurse do before applying the ointment?

A nurse is educating a new mother about umbilical cord care and how to prevent omphalitis, sepsis, and tetanus. Which of the following statements by the mother indicates an understanding of the teaching?

A nurse is assessing a newborn who has hypoglycemia due to perinatal asphyxia. Which of the following findings should the nurse expect? (Select all that apply.)

A nurse is caring for a preterm newborn who has hypoglycemia due to inadequate gluconeogenesis. The nurse should understand that this condition occurs because preterm newborns have limited stores of which of the following substances?

A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir).

The nurse should monitor the client for which of the following adverse effects?