Nursing Elites

1. A client is being discharged with a new prescription for an antihypertensive medication. Which of the following statements should the nurse provide?

• A. Be sure to limit your potassium intake while taking the medication.
• B. You should check your blood pressure every 8 hours while taking this medication.
• C. Your medication dosage will be increased if you develop tachycardia.
• D. Change positions slowly when you move from sitting to standing.

Correct answer: D

Rationale: The correct answer is D. Orthostatic hypotension is a common adverse effect of antihypertensive medications. The client should move slowly to a sitting or standing position and should be taught to sit or lie down if lightheadedness or dizziness occurs. Choices A, B, and C are incorrect. Limiting potassium intake is usually not necessary with antihypertensive medications. Checking blood pressure every 8 hours is not a standard recommendation unless specified by a healthcare provider. Increasing medication dosage due to tachycardia is not a typical practice for antihypertensive medications.

2. When providing teaching to a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a side effect that affects the gums. It is crucial for the client to maintain good oral hygiene to prevent oral health complications. Choices A, B, and D are incorrect. While the timing of medication administration and dietary considerations are important, they are not directly related to preventing the specific side effect of gingival hyperplasia caused by Phenytoin.

3. What is an expected outcome for Lithium use in patients with bipolar disorder?

• A. Reduced risk of myocardial infarction
• B. Reduced risk of GI ulcers
• C. Decrease in respiratory distress
• D. Decreased incidence of acute manic episodes

Correct answer: D

Rationale: The correct answer is D: Decreased incidence of acute manic episodes. Lithium is commonly used to treat bipolar disorder by helping to stabilize mood and reduce the intensity and frequency of manic episodes. This leads to better overall management of the disorder. Choices A, B, and C are incorrect because lithium is not known to reduce the risk of myocardial infarction, GI ulcers, or respiratory distress in patients with bipolar disorder.

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 educating a client who is starting therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The healthcare professional should instruct the client to report dyspnea since it can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Monitoring and reporting dyspnea promptly can help in early detection and management of potential serious complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are not urgent findings requiring immediate reporting.

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