The client taking cyclosporine to prevent liver transplant rejection calls the clinic to report a sore throat. The nurse will
Advise the patient to drink warm tea with honey and stay home
Ask the patient about fever and report the call to the provider.
Tell the patient to stop cyclosporine and report the call to the provider.
Reassure the client that this is an expected effect and will resolve.
The Correct Answer is B
Choice A rationale: A sore throat in a patient taking immunosuppressive medications requires further assessment and intervention beyond home remedies.
Choice B rationale: Assessing for fever is crucial, as an infection in a patient on immunosuppressive therapy can be serious and requires prompt attention.
Choice C rationale: Stopping cyclosporine abruptly without guidance from the provider can lead to rejection; this decision should be made by the healthcare provider.
Choice D rationale: Reassurance alone may not be appropriate, given the potential seriousness of infection in an immunocompromised patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: A blood pressure reading of 72/56 mmHg may be expected after spinal anesthesia. The nurse should continue to monitor the blood pressure to ensure it stabilizes within an acceptable range for the individual patient.
Choice B rationale: Headache is a common side effect of spinal anesthesia, and the nurse should assess for this but should not be the first action with the given blood pressure reading.
Choice C rationale: Administering oxygen by nasal cannula may not be necessary based solely on the blood pressure reading after spinal anesthesia.
Choice D rationale: Elevating the client's feet is not the first intervention for a blood pressure reading of 72/56 mmHg after spinal anesthesia. It may be considered if the blood pressure remains low and symptoms of hypotension are present.
Correct Answer is B
Explanation
Choice A rationale: Dry mouth is a known side effect of clonidine, and denying this information would be inaccurate.
Choice B rationale: Providing strategies to alleviate the side effect, such as offering hard candy or gum, is a proactive approach to managing the dry mouth without discontinuing the medication.
Choice C rationale: Stopping antihypertensive medication abruptly can lead to rebound hypertension, and the nurse should not encourage discontinuation without consulting the healthcare provider.
Choice D rationale: Adjusting the dose of clonidine should be done under the guidance of a healthcare provider; self-adjustment without professional input is not advisable.
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