Nursing Elites

1. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: The correct answer is 'Orthostatic hypotension.' When administering Amitriptyline, the nurse should monitor for orthostatic hypotension. This condition can occur due to the drug's anticholinergic effects, leading to a sudden drop in blood pressure when standing up. Symptoms may include dizziness, lightheadedness, and an increased risk of falls. Monitoring for signs of orthostatic hypotension is crucial to prevent complications. Choices A, B, and C are incorrect as decreased appetite, explosive diarrhea, and decreased pulse rate are not typically associated with the administration of Amitriptyline.

2. A client has been prescribed Aspirin for prevention of cardiovascular disease. Which of the following findings indicates the medication is effective?

• A. The client has a decrease in troponin levels.
• B. The client has a regular heart rhythm.
• C. The client experiences a decrease in episodes of angina.
• D. The client's blood pressure remains stable.

Correct answer: C

Rationale: The correct answer is C. A decrease in episodes of angina indicates that Aspirin is effectively preventing the formation of clots that could lead to cardiovascular events. Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, usually due to coronary artery disease. Aspirin works by inhibiting platelet aggregation, thereby reducing the risk of clot formation in the arteries. Improvement in angina symptoms suggests that the medication is successfully preventing clot-related complications in the cardiovascular system. Monitoring and recognizing a decrease in angina episodes can be a valuable indicator of the medication's efficacy in preventing cardiovascular events. Choices A, B, and D are incorrect because a decrease in troponin levels, a regular heart rhythm, or stable blood pressure, while important parameters, do not directly reflect the effectiveness of Aspirin in preventing cardiovascular events through antiplatelet action.

3. When teaching a client about preventing Otitis Externa, which of the following instructions should the nurse include?

• A. Clean the ear with a cotton-tipped swab daily.
• B. Place earplugs in the ears when sleeping at night.
• C. Use a cool water irrigation solution to remove earwax.
• D. Tip the head to the side to remove water from the ears after showering.

Correct answer: D

Rationale: To prevent Otitis Externa, the nurse should instruct the client to tip the head to the side to allow water to drain out after showering or swimming. This helps to prevent moisture buildup in the ear canal, reducing the risk of developing Otitis Externa, commonly known as swimmer's ear.

4. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

5. A client with a UTI and a history of recurrent infections asks why the provider has not yet prescribed an antibiotic. The nurse should explain that the provider has to wait for the results of which of the following laboratory tests to identify which antibiotic to prescribe?

• A. Gram stain
• B. Culture
• C. Sensitivity
• D. Specific gravity

Correct answer: C

Rationale: In the case of a UTI, a sensitivity test is crucial as it identifies the most effective antibiotic to target the specific microorganism causing the infection. This test helps in prescribing the appropriate antibiotic for successful treatment and preventing antibiotic resistance. While a Gram stain and culture are important in diagnosing a UTI, the sensitivity test specifically determines the most suitable antibiotic. Specific gravity, on the other hand, is not related to identifying the appropriate antibiotic for a UTI.

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