A nurse is caring for a client who has chronic hepatitis C and reports taking acetaminophen daily for headaches.The nurse should monitor the client for which of the following adverse effects?

Hepatic necrosis

Pulmonary fibrosis

Pancreatitis

Cardiac dysrhythmias.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. Hepatic necrosis. Acetaminophen (APAP) is a common cause of drug-induced liver injury and can lead to hepatic necrosis, especially in patients who have chronic hepatitis C. APAP is metabolized by the liver and produces a toxic intermediate called N-acetyl-p-benzoquinone imine (NAPQI), which can deplete glutathione and damage hepatocytes. Patients who have chronic hepatitis C may have reduced glutathione levels and increased oxidative stress, making them more susceptible to APAP toxicity.

Choice B. Pulmonary fibrosis is wrong because APAP does not cause pulmonary fibrosis.

Pulmonary fibrosis is a chronic lung disease that involves scarring of the lung tissue and impaired gas exchange. Some drugs that can cause pulmonary fibrosis are amiodarone, bleomycin, methotrexate and nitrofurantoin.

Choice C. Pancreatitis is wrong because APAP does not cause pancreatitis.

Pancreatitis is an inflammation of the pancreas that can result from gallstones, alcohol abuse, hypertriglyceridemia, hypercalcemia, infections, trauma or certain medications.

Some drugs that can cause pancreatitis are azathioprine, valproic acid, didanosine and pentamidine.

Choice D. Cardiac dysrhythmias is wrong because APAP does not cause cardiac dysrhythmias.

Cardiac dysrhythmias are abnormal heart rhythms that can result from electrolyte imbalances, ischemia, myocardial infarction, heart failure, congenital defects or certain medications.

Some drugs that can cause cardiac dysrhythmias are digoxin, quinidine, sotalol and erythromycin.

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Correct Answer is A

Explanation

The correct answer is choice A. Serum calcium.Etidronate is a bisphosphonate that inhibits bone resorption and reduces the risk of skeletal complications in patients with cancer-related bone pain.However, it can also cause hypocalcemia (low serum calcium levels) as a side effect, which can lead to muscle spasms, numbness, tingling, seizures, and cardiac arrhythmias.

Therefore, the nurse should monitor the patient’s serum calcium levels regularly and supplement with calcium and vitamin D if needed.

Choice B. Serum potassium is wrong because etidronate does not affect potassium levels.Potassium is mainly regulated by the kidneys and can be altered by renal impairment, dehydration, acid-base imbalance, or medications such as diuretics or potassium-sparing agents.

Choice C. Serum creatinine is wrong because etidronate does not affect creatinine levels.

Creatinine is a waste product of muscle metabolism that is excreted by the kidneys.It reflects the glomerular filtration rate (GFR) and can be elevated in renal dysfunction or dehydration.

Choice D. Serum albumin is wrong because etidronate does not affect albumin levels.

Albumin is a protein that is synthesized by the liver and helps maintain fluid balance and transport substances in the blood.It can be decreased in liver disease, malnutrition, inflammation, or protein-losing conditions.

A. “I can use meditation to help me relax and cope with pain.”. B. “I can apply cold packs to the painful area for up to 30 minutes.”. C. “I can listen to music or watch a funny show to distract myself from pain.”. D. “I can massage the painful area with firm pressure to relieve muscle tension.”. E. “I can take a warm bath or shower to soothe the painful area.”.

Correct Answer is ["A","C","E"]

Explanation

The correct answer is choice A, C and E. These statements indicate that the client understands the teaching about nonpharmacological pain management techniques.

• Choice A is correct becausemeditationcan help the client relax and cope with pain by reducing stress and anxiety.

• Choice C is correct becausedistractioncan help the client divert attention from pain by engaging in enjoyable or stimulating activities.

• Choice E is correct becauseheatcan help the client soothe the painful area by increasing blood flow and relaxing muscles.

• Choice B is wrong becausecold packsshould not be applied to the painful area for more than15 minutesat a time, as they can cause tissue damage or frostbite.

• Choice D is wrong becausemassageshould not be done with firm pressure, as it can aggravate the pain or cause injury.Gentle massage may be beneficial for some clients.

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A nurse is caring for a client who has chronic hepatitis C and reports taking acetaminophen daily for headaches.The nurse should monitor the client for which of the following adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with cancer-related bone pain is receiving etidronate as an adjuvant analgesic. The nurse should monitor the patient for which of the following laboratory values?

Correct Answer is A

Explanation

A nurse is teaching a client who has chronic pain about nonpharmacological pain management techniques. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.).

Correct Answer is ["A","C","E"]

Explanation

A nurse is providing discharge teaching to a client who has a prescription for acetaminophen and hydrocodone (Vicodin).Which of the following instructions should the nurse include in the teaching?

A nurse is educating a patient who has been prescribed aspirin for the prevention of cardiovascular events. Which of the following instructions should the nurse include? (Select all that apply.)

A nurse is caring for a patient who has been prescribed fentanyl patches for chronic cancer pain management at home. Which statement by the patient indicates that he understands how to use this medication safely?

A client with osteoarthritis has been prescribed celecoxib (Celebrex). The nurse should instruct the client to report which of the following adverse effects immediately?

A nurse is educating a client about ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), that has been prescribed for moderate pain and inflammation. Which of the following instructions should the nurse include? (Select all that apply.).

A nurse is caring for a patient who is receiving epidural analgesia with buprenorphine (Buprenex). Which assessment finding would indicate that an adverse effect may be occurring?

The nurse is preparing to administer morphine sulfate, an opioid analgesic, to a client who reports pain at level 8 on a scale of 0 to 10. Which action should the nurse take first?

A patient who has chronic low back pain is prescribed oxycodone (OxyContin) for long-term use. Which of the following interventions should the nurse implement to prevent complications from this medication? (Select all that apply.)