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 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.

3. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

4. A client is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion?

• A. I signed up for a swimming class.
• B. I've been taking an antacid to help with indigestion.
• C. I've lost 2 pounds since my appointment 2 weeks ago.
• D. The naproxen is easier to take when I crush it and put it in applesauce.

Correct answer: B

Rationale: The client stating that they have been taking an antacid to help with indigestion while on naproxen requires further discussion. This statement suggests potential gastrointestinal distress or interactions between the medications. Antacids can affect the absorption of naproxen or lead to other complications. Therefore, the nurse should address this statement with the client to ensure safe and effective medication management. Choices A, C, and D do not raise immediate concerns related to the client's medication regimen and can be considered positive health behaviors or side effects of treatment that do not require immediate intervention.

5. What is the therapeutic use of metformin?

• A. Lower blood pressure
• B. Diminish seizure activity
• C. The maintenance of a person's blood glucose levels
• D. Increase heart rate and decrease gastrointestinal secretions

Correct answer: C

Rationale: Metformin is commonly prescribed to manage and control blood glucose levels in individuals with diabetes. It helps in reducing the amount of glucose produced by the liver and improves the body's response to insulin, thereby aiding in the regulation of blood sugar levels. It is not used to lower blood pressure, diminish seizure activity, increase heart rate, or decrease gastrointestinal secretions.

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