The practical nurse assesses a client who is receiving carbamazepine for a seizure disorder. The client reports the onset of a sore throat. Which additional assessment data should the PN obtain before reporting to the charge nurse?

Appearance of the gums

Bowel sounds

Carotid artery pulse volume

Temperature

Answer and Explanation

The Correct Answer is D

Choice A reason: Gum appearance is unrelated to carbamazepine’s side effects or sore throat. While some antiseizure drugs cause gingival hyperplasia, carbamazepine does not, and gum assessment does not clarify the sore throat’s cause, which may indicate infection or agranulocytosis, making this choice irrelevant.

Choice B reason: Bowel sounds assess gastrointestinal function, not relevant to a sore throat or carbamazepine’s effects. Sore throat may signal agranulocytosis, a rare side effect, but bowel sounds do not provide data on infection or hematologic issues, making this choice inappropriate.

Choice C reason: Carotid pulse volume evaluates cardiovascular status but is unrelated to sore throat or carbamazepine’s side effects. Sore throat may indicate infection or agranulocytosis, requiring systemic assessment like temperature, not vascular checks, making this choice irrelevant for the reported symptom.

Choice D reason: Temperature is critical, as sore throat may indicate infection or agranulocytosis, a rare but serious carbamazepine side effect causing low white blood cells. Fever suggests infection, necessitating urgent reporting. This assessment provides key data to differentiate causes, guiding timely intervention.

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Correct Answer is B

Explanation

Choice A reason: Taking medications with food may reduce gastric irritation but does not prevent anaphylactic reactions to penicillin, which are immune-mediated. This advice is irrelevant for avoiding future allergic responses, as it does not address the systemic hypersensitivity triggered by penicillin exposure.

Choice B reason: A medic alert bracelet is critical for a client with a penicillin anaphylaxis history, as it alerts healthcare providers to avoid penicillin, preventing potentially fatal allergic reactions. Anaphylaxis involves IgE-mediated histamine release, and re-exposure risks rapid, life-threatening symptoms, making this the most important instruction.

Choice C reason: Keeping epinephrine is useful for managing anaphylaxis but is secondary to prevention. A medic alert bracelet proactively avoids penicillin exposure, reducing the need for emergency intervention. Epinephrine treats symptoms but does not address the root cause of re-exposure risk.

Choice D reason: Taking all prescribed ampicillin is dangerous, as the client had an anaphylactic reaction, indicating a severe allergy. Continuing the drug risks recurrent, potentially fatal reactions. This choice is incorrect, as it contradicts the need to avoid the allergen entirely.

A. Reduced epigastric pain B. Loss of 3 pounds (1.36 kg) in a month C. Decreased nighttime awakenings D. Positive stool antigen test

Correct Answer is A

Explanation

Choice A reason: Famotidine, an H2 receptor blocker, reduces gastric acid production, alleviating epigastric pain caused by acid-related conditions like gastritis or ulcers. Decreased pain indicates the drug’s effectiveness in lowering acid levels, protecting the gastric mucosa, and promoting healing, making this the primary clinical outcome.

Choice B reason: Weight loss of 3 pounds is not a direct indicator of famotidine’s effectiveness. It may result from unrelated factors like diet or illness. Famotidine targets acid reduction, not weight, so this finding is irrelevant to assessing the drug’s therapeutic impact on gastric conditions.

Choice C reason: Decreased nighttime awakenings may occur with reduced pain but are not a specific measure of famotidine’s effectiveness. Awakenings could relate to other factors, like sleep disorders. Pain reduction is a more direct indicator of the drug’s action on acid-related symptoms.

Choice D reason: A positive stool antigen test indicates Helicobacter pylori infection, not famotidine’s effectiveness. Famotidine reduces acid but does not eradicate H. pylori, which requires antibiotics. This finding is unrelated to the drug’s primary role in acid suppression and symptom relief.

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The practical nurse assesses a client who is receiving carbamazepine for a seizure disorder. The client reports the onset of a sore throat. Which additional assessment data should the PN obtain before reporting to the charge nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is discharging a client who had an anaphylactic reaction following administration of ampicillin. Which instruction is most important for the PN to provide this client?

Correct Answer is B

Explanation

A client receives a prescription for intravenous (IV) famotidine. Which finding indicates to the practical nurse (PN) the medication is effective?

Correct Answer is A

Explanation

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