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 has a new prescription for Lisinopril. Which of the following adverse effects should the nurse monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: The correct answer is 'Dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. If the client experiences this, it is important to notify the healthcare provider for further evaluation and management.

3. A client has been prescribed Prednisone for an inflammatory condition and is receiving discharge teaching from a nurse. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Avoid alcohol while taking this medication.
• C. Monitor your blood pressure regularly.
• D. Take this medication in the morning to prevent insomnia.

Correct answer: D

Rationale: The correct answer is to take Prednisone in the morning to prevent insomnia. Prednisone can cause insomnia as a side effect, so taking it in the morning can help minimize this issue. It is important to follow the healthcare provider's instructions regarding the timing of Prednisone administration to optimize its effectiveness and minimize adverse effects.

4. A client is receiving discharge instructions for a new prescription of Enoxaparin. Which of the following instructions should the provider include?

• A. Inject the medication into the muscle.
• B. Massage the injection site after administration.
• C. Rotate injection sites between the arms and thighs.
• D. Administer the medication in the abdomen.

Correct answer: D

Rationale: The correct answer is to administer the medication in the abdomen. Enoxaparin is administered as a subcutaneous injection in the abdomen to prevent bleeding complications. Injecting into the muscle or massaging the site can increase the risk of bleeding. Rotating sites between the arms and thighs is not recommended for Enoxaparin administration due to variations in absorption rates. Therefore, the provider should instruct the client to administer Enoxaparin in the abdomen for optimal effectiveness and safety.

5. A client has a new prescription for Levothyroxine to treat hypothyroidism. Which of the following instructions should be included in the teaching?

• A. Take this medication with food.
• B. Take this medication at bedtime.
• C. Expect to see results in 1 week.
• D. Do not discontinue the medication without consulting the provider.

Correct answer: D

Rationale: The correct instruction for a client with a new prescription for Levothyroxine to treat hypothyroidism is not to discontinue the medication without consulting the provider. Abrupt cessation could lead to the return of hypothyroid symptoms, emphasizing the importance of medical guidance when considering any changes to the treatment plan. Choice A is incorrect because Levothyroxine should be taken on an empty stomach, typically in the morning. Choice B is incorrect as it contradicts the timing of administration for Levothyroxine. Choice C is inaccurate as it usually takes a few weeks for the full effects of Levothyroxine to be seen, not just 1 week.

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