Nursing Elites

1. A client has a new prescription for Verapamil to treat angina. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of Verapamil?

• A. I am frequently constipated.
• B. I have been urinating more frequently.
• C. My skin is peeling.
• D. I have ringing in my ears.

Correct answer: A

Rationale: The correct answer is A: 'I am frequently constipated.' Constipation is a common adverse effect of Verapamil, a calcium channel blocker. Verapamil can slow down intestinal motility, leading to constipation as a side effect. Choices B, C, and D are not typically associated with adverse effects of Verapamil. Increased urination is not a common side effect, skin peeling is not related to Verapamil use, and ringing in the ears is not a typical adverse effect of this medication.

2. A client has a new prescription for Metronidazole to treat an infection. Which of the following instructions should the nurse include?

• A. Avoid alcohol while taking this medication.
• B. Take this medication on an empty stomach.
• C. Increase your intake of dairy products while taking this medication.
• D. Avoid direct sunlight while taking this medication.

Correct answer: A

Rationale: The correct instruction is to avoid alcohol while taking Metronidazole. This is crucial to prevent a disulfiram-like reaction, which can result in severe nausea and vomiting. Alcohol should be avoided for at least 48 hours after completing the medication course as well. Choice B is incorrect because Metronidazole can be taken with food to reduce gastrointestinal side effects. Choice C is incorrect because there is no need to increase dairy product intake while on Metronidazole. Choice D is incorrect because there is no specific instruction to avoid direct sunlight while taking this medication.

3. A client is receiving Enoxaparin for the prevention of deep vein thrombosis. Which of the following actions should the nurse take?

• A. Massage the injection site after administration.
• B. Administer the medication intramuscularly.
• C. Administer the medication into the subcutaneous tissue.
• D. Administer the medication into the deltoid muscle.

Correct answer: C

Rationale: Enoxaparin, a medication used for preventing deep vein thrombosis, should be administered into the subcutaneous tissue, typically in the abdomen. Administering the medication intramuscularly (Choice B) or into the deltoid muscle (Choice D) is incorrect because Enoxaparin is specifically formulated for subcutaneous administration. Massaging the injection site after administration (Choice A) is contraindicated as it may lead to tissue damage and affect the absorption of the medication. Therefore, the correct action is to administer the medication into the subcutaneous tissue as directed.

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

• A. Notify the provider if you plan to become pregnant.
• B. Take the medication 1 hour before planning to go to sleep.
• C. Allow at least 6 hours for sleep when taking zolpidem.
• D. Do not take zolpidem with a bedtime snack.

Correct answer: A

Rationale: Zolpidem is classified as Pregnancy Risk Category C. It is important for the client to inform the provider if they plan to become pregnant because the medication may need to be adjusted or changed to ensure the safety of the fetus. This communication allows for appropriate monitoring and adjustments to be made to the treatment plan. Choice B is incorrect because zolpidem should be taken just before going to bed, not specifically 1 hour before. Choice C is incorrect as zolpidem is a short-acting medication, and it does not require a full 6 hours for sleep. Choice D is incorrect because zolpidem can be taken with or without food, so taking it with a bedtime snack is not contraindicated.

5. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?

• A. Excessive doxorubicin can result in myelosuppression.
• B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
• C. An excess amount of doxorubicin can lead to cardiomyopathy.
• D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.

Correct answer: C

Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.

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