Question

A female client who has been taking oral contraceptives for the past year comes into the clinic for an annual exam. Which finding is most important for the practical nurse (PN) to report to the healthcare provider (HCP)?

Answer 1

Correct Answers:

Left calf pain.

Rationale :

🔷 Oral contraceptives increase the risk of venous thromboembolism (VTE) due to their effect on clotting factors.

🔷 Calf pain can indicate deep vein thrombosis (DVT), which can progress to pulmonary embolism—a life-threatening complication.

🔷 Breast tenderness, weight gain, and changes in menstrual flow are common side effects but not urgent to report.

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Answer 2

Correct Answers:

Monitor the client's blood glucose levels.

Rationale :

💠 Exenatide is a GLP-1 receptor agonist that lowers postprandial blood glucose by enhancing insulin secretion and slowing gastric emptying.

💠 The best way to determine medication effectiveness is to check blood glucose levels after meals.

💠 Nausea and appetite changes are side effects, but they do not indicate effectiveness.

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Answer 3

Correct Answers:

Reduced muscular back spasms and surgical pain.

Rationale :

🔶 Cyclobenzaprine is a muscle relaxant prescribed to relieve muscle spasms and associated pain.

🔶 The PN should first evaluate if the client’s pain and spasms are relieved, as this is the intended therapeutic effect.

🔶 Distal movement is a neurovascular assessment, drowsiness is a side effect, and posture is not the primary goal.

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Answer 4

Correct Answers:

Observe the client's skin for bruising.

Rationale :

🟡 Immunosuppressants increase the risk of bone marrow suppression, leading to low platelets and potential bleeding.

🟡 Bruising is an early indicator of hematologic complications and must be monitored closely.

🟡 Bowel sounds, weight, and I&O are important in general care but not the most direct way to detect adverse effects.

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Answer 5

Correct Answers:

Heart rate.

Rationale :

🟢 Levothyroxine can cause tachycardia and palpitations if the dose is too high, especially in older adults.

🟢 Monitoring heart rate is critical to detect early signs of toxicity and prevent cardiac complications.

🟢 Sleep, weight, and appetite may change, but heart rate monitoring is most important.

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Answer 6

Correct Answers:

Rinse the mouth out after dosing.

Rationale :

🔴 Fluticasone is an inhaled corticosteroid that may cause oral candidiasis (thrush) if the mouth is not rinsed.

🔴 The client must rinse after each use to reduce fungal growth risk.

🔴 It is not used for acute asthma attacks—only maintenance therapy. Sunlight avoidance and pulse monitoring are unrelated.

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Answer 7

Correct Answers:

Protect skin from injury and bruising.

Rationale :

⚪ The client is on an anticoagulant (risk for bleeding) and phenytoin, which may alter clotting and increase risk of bruising.

⚪ UAPs should be instructed to use gentle care, avoid bumping or rough handling, and report bruises or bleeding.

⚪ Turning schedules, leg elevation, and frequent temperature checks are not the main priorities in this drug combination.

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Answer 8

Correct Answers:

Reports experiencing satisfactory level of comfort.

Rationale :

🟤 The most important documentation after giving ketorolac (NSAID analgesic) is the client’s pain relief and comfort level.

🟤 Pain management is the therapeutic goal; observing sleep or activity tolerance may occur later but are not primary measures.

🟤 Family activities are not direct indicators of medication effectiveness.

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Answer 9

Correct Answers:

Cover the site with an occlusive dressing.

Rationale :

🔷 Betamethasone is a topical corticosteroid that should not routinely be covered with occlusive dressings unless specifically ordered, as this increases systemic absorption and side effects.

🔷 Using on intact skin (A), limiting sunlight (B), and applying for a prescribed period such as 2 weeks (D) are correct practices.

🔷 Reinforcement is needed because occlusion can lead to skin atrophy and systemic corticosteroid effects.

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Answer 10

Correct Answers:

Dizziness.

Rationale :

💠 Carbidopa-levodopa can cause orthostatic hypotension and dizziness, which may increase fall risk.

💠 This finding requires assessment before giving the medication to ensure client safety.

💠 The other findings (pill rolling, flat affect, anorexia) are expected symptoms of Parkinson’s disease rather than contraindications to medication administration.

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QLexNursing

1 :
A female client who has been taking oral contraceptives for the past year comes into the clinic for an annual exam. Which finding is most important for the practical nurse (PN) to report to the healthcare provider (HCP)?

2 :
The practical nurse (PN) administers exenatide subcutaneous one hour before breakfast to a client with diabetes mellitus. Which action should the PN take to determine if the medication was effective?

3 :
The practical nurse (PN) is administering cyclobenzaprine to a client who had a lumbar laminectomy. The PN should evaluate for which therapeutic responses first?

4 :
A practical nurse (PN) is caring for a client with multiple sclerosis (MS) who is receiving an immunosuppressant. Which action is most important for the PN to implement to evaluate for adverse effects from the medication?

5 :
The practical nurse (PN) is providing discharge instructions to a client who had a partial thyroidectomy. When explaining the actions of the prescribed thyroid supplement, levothyroxine sodium, which parameter should the PN tell the client is most important to monitor for potential side effects?

6 :
A client with asthma receives a prescription for fluticasone, a metered-dose inhaler. Which instruction should the practical nurse (PN) reinforce?

7 :
The practical nurse (PN) reviews a client's medication history and learns that the client takes an anticoagulant and has recently started taking phenytoin. Which instruction should the PN provide when assigning the client's morning care to an unlicensed assistive personnel (UAP)?

8 :
A client is to receive ketorolac IV for acute back pain of moderate severity. After administering the medication, which information is most important for the practical nurse (PN) to document?

9 :
A client with eczema receives a prescription for betamethasone cream. Which client statement indicates to the practical nurse (PN) that reinforcement of teaching is needed?

10 :
The practical nurse (PN) is preparing to administer carbidopa-levodopa to a client with Parkinson's disease. Which client finding requires further assessment before administering the medication?

QLexNursing

1 : A female client who has been taking oral contraceptives for the past year comes into the clinic for an annual exam. Which finding is most important for the practical nurse (PN) to report to the healthcare provider (HCP)?

2 : The practical nurse (PN) administers exenatide subcutaneous one hour before breakfast to a client with diabetes mellitus. Which action should the PN take to determine if the medication was effective?

3 : The practical nurse (PN) is administering cyclobenzaprine to a client who had a lumbar laminectomy. The PN should evaluate for which therapeutic responses first?

4 : A practical nurse (PN) is caring for a client with multiple sclerosis (MS) who is receiving an immunosuppressant. Which action is most important for the PN to implement to evaluate for adverse effects from the medication?

6 : A client with asthma receives a prescription for fluticasone, a metered-dose inhaler. Which instruction should the practical nurse (PN) reinforce?

7 : The practical nurse (PN) reviews a client's medication history and learns that the client takes an anticoagulant and has recently started taking phenytoin. Which instruction should the PN provide when assigning the client's morning care to an unlicensed assistive personnel (UAP)?

8 : A client is to receive ketorolac IV for acute back pain of moderate severity. After administering the medication, which information is most important for the practical nurse (PN) to document?

9 : A client with eczema receives a prescription for betamethasone cream. Which client statement indicates to the practical nurse (PN) that reinforcement of teaching is needed?

10 : The practical nurse (PN) is preparing to administer carbidopa-levodopa to a client with Parkinson's disease. Which client finding requires further assessment before administering the medication?

1 :
A female client who has been taking oral contraceptives for the past year comes into the clinic for an annual exam. Which finding is most important for the practical nurse (PN) to report to the healthcare provider (HCP)?

2 :
The practical nurse (PN) administers exenatide subcutaneous one hour before breakfast to a client with diabetes mellitus. Which action should the PN take to determine if the medication was effective?

3 :
The practical nurse (PN) is administering cyclobenzaprine to a client who had a lumbar laminectomy. The PN should evaluate for which therapeutic responses first?

4 :
A practical nurse (PN) is caring for a client with multiple sclerosis (MS) who is receiving an immunosuppressant. Which action is most important for the PN to implement to evaluate for adverse effects from the medication?

6 :
A client with asthma receives a prescription for fluticasone, a metered-dose inhaler. Which instruction should the practical nurse (PN) reinforce?

7 :
The practical nurse (PN) reviews a client's medication history and learns that the client takes an anticoagulant and has recently started taking phenytoin. Which instruction should the PN provide when assigning the client's morning care to an unlicensed assistive personnel (UAP)?

8 :
A client is to receive ketorolac IV for acute back pain of moderate severity. After administering the medication, which information is most important for the practical nurse (PN) to document?

9 :
A client with eczema receives a prescription for betamethasone cream. Which client statement indicates to the practical nurse (PN) that reinforcement of teaching is needed?

10 :
The practical nurse (PN) is preparing to administer carbidopa-levodopa to a client with Parkinson's disease. Which client finding requires further assessment before administering the medication?