A nurse is caring for a female client in an outpatient clinic.

Exhibits

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Nurses' Notes

Day 1:

Client is seen by provider for routine follow-up after being started on axcarbazepine 150mg PO twice a day, last week. Client reports no nausea, headache, dizziness, or ataxia. Provider increased oxcarbazepine to 300 mg PO twice a day. Client is to return for a follow-up in 2 weeks.

Day 14:

Client returns for follow-up after increasing oxcarbazepine dosage. Client reports starting to have mild headaches earlier this week. Also states, "Yesterday I was very nauseated and threw up before breakfast." When talking to client they have difficulty remembering the times they are taking their axcarbazepine. Client reports using oral contraceptives as the only means of birth control.

Laboratory Results

Day 14

Hct 40% (37% to 47%)

Hgb 13g/dL (12 to 16g/dL)

Sodium 124 mEq/L (136 to 145 mEq/L)

Vitals Signs

Day 14:

Temperature 36.3°C (97.4° F)

Heart rate 86/min

mild headaches

Yesterday I was very nauseated and threw up before breakfast

difficulty remembering the times they are taking their axcarbazepine

Sodium 124 mEq/L (136 to 145 mEq/L)

Hct 40% (37% to 47%)

Answer and Explanation

The Correct Answer is ["A","B","C","D"]

Nurses' Notes Day 1:

Client is seen by provider for routine follow-up after being started on axcarbazepine 150mg PO twice a day, last week. Client reports no nausea, headache, dizziness, or ataxia. Provider increased oxcarbazepine to 300 mg PO twice a day. Client is to return for a follow-up in 2 weeks.

Day 14:

Client returns for follow-up after increasing oxcarbazepine dosage. Client reports starting to have mild headaches earlier this week. Also states, "Yesterday I was very nauseated and threw up before breakfast." When talking to client they have difficulty remembering the times they are taking their axcarbazepine. Client reports using oral contraceptives as the only means of birth control.

Laboratory Results Day 14

Hct 40% (37% to 47%)

Hgb 13g/dL (12 to 16g/dL)

Sodium 124 mEq/L (136 to 145 mEq/L) Vitals Signs

Day 14:

Temperature 36.3°C (97.4° F)

Heart rate 86/min

Rationale:

The patient's follow-up findings on Day 14, particularly the reported symptoms and laboratory results, suggest potential side effects from the increased dosage of oxcarbazepine. Common side effects of oxcarbazepine include dizziness, nausea, and vomiting. The patient's symptoms of mild headaches and nausea, along with difficulty remembering medication times, could be indicative of these side effects. Additionally, the sodium level of 124 mEq/L is below the normal range (136 to 145 mEq/L), indicating hyponatremia, which is a known side effect of oxcarbazepine and can be serious.

Hyponatremia can cause symptoms such as nausea, vomiting, exhaustion, and dizziness, aligning with the patient's reported condition. These findings warrant immediate medical attention to assess the need for adjusting the medication dosage or considering alternative treatments.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Insulin glargine is a long-acting insulin and should not be taken additionally before exercise; adjustments are usually made with short-acting insulin.
B. Wearing reading glasses will help ensure that the client accurately measures the correct dose, which is essential for safe administration.
C. Insulin is typically injected subcutaneously in areas like the abdomen, thigh, or back of the arm, not the deltoid muscle.
D. Insulin glargine is usually administered once daily at the same time each day, not before each meal.

A. Absence of peripheral neuropathy B. Reduced dizziness C. Decreased nausea D. Increased urinary output

Correct Answer is C

Explanation

A. Ondansetron is an antiemetic and does not address peripheral neuropathy.
B. While dizziness can sometimes be reduced as a secondary benefit, it is not the primary indication for ondansetron.
C. Decreased nausea is the primary indication that ondansetron is effective, as it is used to prevent and treat nausea and vomiting.
D. Increased urinary output is not related to the efficacy of ondansetron.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is developing a teaching plan for an older adult client who has a new prescription for insulin glargine. Which of the following expected outcomes should the nurse include in the plan?

Correct Answer is B

Explanation

A nurse is caring for a client who is receiving ondansetron IV. Which of the following findings is an indication that the ondansetron is effective?

Correct Answer is C

Explanation

A nurse is reviewing a client's medical history before administering a new prescription for atropine. Which of the following client conditions is contraindicated?

A nurse is assessing a client who is taking warfarin. Which of the following findings should the nurse identify as the priority to report to the provider?

A nurse is preparing to titrate a continuous nitroprusside infusion for a client. The nurse should plan to titrate the infusion according to which of the following assessments?

A nurse is caring for a client who is experiencing severe vomiting. Which of the following medications should the nurse plan to administer?

A nurse is caring for a client who has received propofol during a colonoscopy. The nurse should monitor for which of the following as an adverse effect of the medication?

A nurse is providing teaching to a client about how to self-administer subcutaneous injections of enoxaparin. Which of the following instructions should the nurse include?

A charge nurse is orienting a newly licensed nurse about pain management principles related to clients' age. Which of the following information should the newly licensed nurse consider when administering opioids?

A nurse is planning care for a group of clients. Which of the following client's medications should be monitored by the nurse for hearing loss related to a medication interaction?