The nurse is continuing to assist in the care of the client.
Complete the following sentence by using the lists of options.
The nurse should reinforce teaching with the client to
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Rationale for correct choices:
• Monitor body temperature: Paliperidone, an antipsychotic, can increase the risk of neuroleptic malignant syndrome (NMS), a rare but potentially life-threatening condition characterized by hyperthermia, muscle rigidity, and altered mental status. Teaching the client to monitor body temperature helps with early recognition of NMS and timely intervention.
• Report sore throat: Paliperidone can cause hematologic adverse effects, including leukopenia, neutropenia, and agranulocytosis. A sore throat may be an early sign of infection due to low white blood cell counts. Reinforcing the need to report symptoms like sore throat ensures prompt evaluation and prevents serious complications.
Rationale for incorrect choices:
• Anticipated increased bruising: Although some antipsychotics may rarely affect platelet function, paliperidone is not commonly associated with increased bruising. This is not a primary teaching point for the client. Monitoring for bruising is less critical than monitoring for signs of infection or NMS.
• Stop taking contraceptive medication: There is no evidence that paliperidone interacts with contraceptives in a way that requires discontinuation. Advising the client to stop contraceptive medication is unnecessary and could place the client at risk for unintended pregnancy.
• Expect weight loss: Paliperidone is more commonly associated with weight gain rather than weight loss. Counseling the client about expecting weight loss would be inaccurate and could mislead them regarding lifestyle and dietary management.
• Follow a low-sodium diet: Paliperidone does not require sodium restriction. Low-sodium diet recommendations are not indicated unless the client has a comorbid condition like hypertension or heart failure. This is unrelated to the medication’s primary safety concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Polio: The inactivated polio vaccine does not contain live virus and does not increase bleeding risk in clients with thrombocytopenia. It is generally considered safe to administer and does not worsen platelet destruction. Routine immunization schedules can usually be continued with this vaccine.
B. Measles, mumps, and rubella virus: The MMR vaccine is a live attenuated vaccine and is associated with the development or worsening of thrombocytopenia. In a client with idiopathic thrombocytopenic purpura, this vaccine should be withheld due to the risk of further platelet reduction and bleeding complications. Careful timing or deferral is recommended until platelet counts stabilize.
C. Diphtheria and tetanus toxoids and pertussis: This vaccine is inactivated and does not pose a risk of viral replication or immune-mediated platelet destruction. While injection technique may need to be adjusted to reduce bleeding risk, the vaccine itself is not contraindicated.
D. Hepatitis B: Hepatitis B vaccine is non-live and safe for clients with thrombocytopenia. Although intramuscular injections can increase the risk of localized bleeding, the vaccine itself does not exacerbate ITP. Applying firm pressure after injection helps minimize bruising or hematoma formation.
Correct Answer is A
Explanation
A. Wheat bread: Wheat bread is relatively low in potassium compared with fruits, vegetables, and juices. It is generally appropriate for clients who require potassium restriction due to renal disease or certain electrolyte imbalances.
B. Orange juice: Orange juice is high in potassium and can significantly increase serum potassium levels. It is commonly restricted in clients who must limit potassium intake to prevent hyperkalemia.
C. Sweet potato: Sweet potatoes contain a high amount of potassium, especially when baked or mashed. They are typically avoided in low-potassium diets because they can rapidly elevate potassium levels.
D. Canned green beans: Although canned vegetables have less potassium than fresh ones due to processing, green beans still contain more potassium than wheat bread. They are not the lowest potassium option.
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