Nursing Elites

1. A client has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?

• A. Orthostatic hypotension
• B. Hearing loss
• C. Gastrointestinal bleeding
• D. Weight loss

Correct answer: A

Rationale: Orthostatic hypotension is a known adverse effect of MAOIs, such as Phenelzine. It is characterized by a drop in blood pressure upon standing, which can lead to dizziness or fainting. Monitoring for orthostatic hypotension is crucial when administering MAOIs to prevent potential complications. Hearing loss (Choice B) is not a typical adverse effect associated with Phenelzine. Gastrointestinal bleeding (Choice C) is more commonly linked to NSAIDs or anticoagulants. Weight loss (Choice D) is not a typical adverse effect of Phenelzine and is more likely related to other factors such as appetite changes or metabolic issues.

2. A client is starting a course of Metronidazole to treat an infection. For which of the following adverse effects should the client stop taking Metronidazole and notify the provider?

• A. Metallic taste
• B. Nausea
• C. Ataxia
• D. Dark-colored urine

Correct answer: C

Rationale: The correct answer is C, 'Ataxia.' Ataxia is a sign of central nervous system (CNS) toxicity, which can be a severe adverse effect of Metronidazole. Metallic taste and nausea are common side effects of Metronidazole but do not require stopping the medication unless they persist or worsen. Dark-colored urine is not typically associated with Metronidazole and does not indicate a severe adverse effect.

3. A client has a new prescription for Prednisone. Which of the following laboratory values should be monitored by the healthcare provider?

• A. Serum potassium
• B. Serum calcium
• C. Serum sodium
• D. Serum glucose

Correct answer: D

Rationale: When a client is prescribed Prednisone, monitoring serum glucose levels is essential. Prednisone, a corticosteroid, can lead to hyperglycemia. Therefore, regular monitoring of serum glucose helps in detecting and managing any potential hyperglycemic effects of the medication. Monitoring serum potassium, calcium, or sodium is not typically required when a client is on Prednisone unless there are specific risk factors or concerns related to these electrolytes.

4. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.

5. What is a common side effect that typically occurs with the initial therapy of Nitroglycerine as a result of increased vasodilation?

• A. Abdominal cramps
• B. Calf pain
• C. Headache
• D. Blurred vision

Correct answer: C

Rationale: Headache is a common side effect associated with the initial therapy of Nitroglycerine due to its vasodilatory properties. The vasodilation caused by Nitroglycerine leads to relaxation of blood vessels, including those in the head, which can result in headaches. This side effect is considered normal and is often transient, diminishing with continued use of the medication.

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