Nursing Elites

1. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of a transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously. Injection-site redness and swelling are common adverse effects. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for any potential issues or reactions.

2. A client is prescribed Diltiazem. Which of the following findings should the nurse monitor?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperkalemia

Correct answer: B

Rationale: Diltiazem is a calcium channel blocker that can cause bradycardia as an adverse effect due to its negative chronotropic properties, slowing down the heart rate. Therefore, the nurse should monitor the client for signs of bradycardia by regularly assessing the heart rate to prevent potential complications. Monitoring for tachycardia (choice A) is incorrect as diltiazem typically does not cause tachycardia. Hypertension (choice C) is not a typical finding to monitor for with diltiazem use. Hyperkalemia (choice D) is not directly associated with diltiazem administration.

3. Which of the following is not directly related to the drug toxicity of Ibuprofen?

• A. Nausea
• B. Renal dysfunction
• C. Anemia
• D. Muscle wasting

Correct answer: D

Rationale: Ibuprofen is known to cause adverse effects such as nausea, renal dysfunction, and anemia. However, muscle wasting is not a common toxicity associated with Ibuprofen use. Therefore, the correct answer is D.

4. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

• A. Somnolence
• B. Constipation
• C. Fluid retention
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Somnolence. Somnolence can indicate lactic acidosis, a rare but serious adverse effect of Metformin. Lactic acidosis is manifested by extreme drowsiness, hyperventilation, and muscle pain. Clients should be instructed to report these symptoms to their healthcare provider promptly to prevent further complications.

5. When instructing a client with a new prescription for Timolol on how to insert eye drops, which area should the nurse instruct the client to press on to prevent systemic absorption of the medication?

• A. Bony orbit
• B. Nasolacrimal duct
• C. Conjunctival sac
• D. Outer canthus

Correct answer: B

Rationale: Pressing on the nasolacrimal duct, located near the inner corner of the eye, blocks the lacrimal punctum and prevents the medication from entering the systemic circulation. This technique helps to ensure the medication stays localized in the eye, enhancing its therapeutic effect while minimizing systemic side effects. Choices A, C, and D are incorrect. The bony orbit is the eye socket and not a site to press for preventing systemic absorption. The conjunctival sac is where eye drops are instilled, not pressed on. The outer canthus is also not the correct area to press to prevent systemic absorption.

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