Nursing Elites

1. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse monitor?

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

Correct answer: A

Rationale: Corrected Rationale: Enalapril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. The nurse should closely monitor the client for this and instruct them to report it to the healthcare provider if it occurs. Choices B, C, and D are incorrect as weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

2. A client has a new prescription for Warfarin. Which of the following statements should the nurse include in the teaching?

• A. You will need to have your blood tested regularly while taking this medication.
• B. It is safe to take over-the-counter NSAIDs with this medication.
• C. You will need to avoid foods high in vitamin K while taking this medication.
• D. You will need to take this medication with food.

Correct answer: C

Rationale: Warfarin interacts with vitamin K, so clients should be instructed to avoid foods high in vitamin K. This is because vitamin K can interfere with the anticoagulant effects of Warfarin. It is important to maintain a consistent intake of vitamin K-containing foods to keep the medication working effectively. Therefore, the correct statement for the nurse to include in the teaching is to advise the client to avoid foods high in vitamin K while taking Warfarin. Choices A, B, and D are incorrect. Regular blood testing is necessary with Warfarin to monitor its effects and adjust the dosage if needed (Choice A). Taking over-the-counter NSAIDs with Warfarin is not safe due to an increased risk of bleeding (Choice B). Warfarin can be taken with or without food, so there is no specific requirement to take it with food (Choice D).

3. At what amount does Acetaminophen stop effectively controlling pain?

• A. Over 1,000 mg
• B. 750 mg
• C. Over 1,500 mg
• D. 150 mg

Correct answer: A

Rationale: Acetaminophen is known to lose its effectiveness in controlling pain beyond a dosage of 1,000 mg. Taking more than 1,000 mg will not provide additional pain relief but can increase the risk of adverse effects. Choice B (750 mg) is incorrect because this amount is within the typical recommended dose range for Acetaminophen. Choice C (Over 1,500 mg) is incorrect as it suggests a higher dose than the point at which Acetaminophen starts to lose its effectiveness. Choice D (150 mg) is too low a dose to effectively control pain for most adults.

4. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?

• A. Inspect the skin for redness and irritation around the injection site.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to lie down for 30 minutes after oral administration.
• D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.

Correct answer: B

Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.

5. A healthcare professional is caring for a client who is prescribed Digoxin. Which of the following findings should the healthcare professional monitor to assess for potential toxicity?

• A. Bradycardia
• B. Hypertension
• C. Hypoglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Bradycardia. Bradycardia is a common sign of Digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. Monitoring the client's heart rate regularly is essential to detect and manage toxicity promptly. Choice B, Hypertension, is incorrect as Digoxin toxicity typically presents with bradycardia and not hypertension. Choices C and D, Hypoglycemia and Hypercalcemia, are also incorrect as they are not typically associated with Digoxin toxicity.

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