Nursing Elites

1. What instructions should the practical nurse (PN) review with a client diagnosed with vaginal trichomoniasis who is prescribed oral metronidazole?

• A. Avoid direct sunlight exposure and use a sunscreen product with SPF100.
• B. The client's sexual partner(s) should also be treated.
• C. Avoid vinegar or commercial product douches.
• D. Eliminate dairy products from the diet during treatment.

Correct answer: B

Rationale: The correct answer is B. The practical nurse should instruct the client that their sexual partner(s) should also be treated when dealing with vaginal trichomoniasis. This is crucial to prevent reinfection as sexual intercourse is the route of spread for this infection. Choices A, C, and D are incorrect. While avoiding direct sunlight exposure and using sunscreen is important for some medications, it is not specifically related to metronidazole treatment for trichomoniasis. Avoiding vinegar or commercial douches is a general recommendation for vaginal health and not specific to this infection. Eliminating dairy products from the diet is not a typical instruction for clients prescribed metronidazole for vaginal trichomoniasis.

2. A client with a history of stroke is prescribed clopidogrel. The nurse should monitor the client for which potential side effect?

• A. Bleeding
• B. Bruising
• C. Nausea
• D. Headache

Correct answer: A

Rationale: Clopidogrel is an antiplatelet medication that works to prevent blood clots, but it can also increase the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, or unusual bleeding from the gums. Prompt identification and management of bleeding are crucial to prevent complications. Choices B, C, and D are incorrect because while bruising and other symptoms can occur as a result of bleeding, they are not the primary side effect to monitor for with clopidogrel. Nausea and headache are less commonly associated with clopidogrel use compared to bleeding.

3. A client with a history of deep vein thrombosis is prescribed enoxaparin. The nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: Enoxaparin is an anticoagulant that works by preventing blood clots. One of the potential adverse effects of enoxaparin is an increased risk of bleeding due to its anticoagulant properties. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, petechiae, or blood in stool or urine, to ensure timely intervention and prevent complications.

4. What instruction should the nurse include in the teaching plan for a client prescribed etanercept for rheumatoid arthritis?

• A. Rotate injection sites to prevent irritation.
• B. Take this medication with food to reduce gastrointestinal upset.
• C. Avoid sunlight exposure while on this medication.
• D. Notify the healthcare provider of any signs of infection.

Correct answer: A

Rationale: The correct instruction for a client prescribed etanercept is to rotate injection sites to prevent irritation and ensure proper absorption. Changing sites will help prevent skin irritation and ensure that the medication is absorbed effectively. This practice also reduces the risk of injection site reactions and discomfort. It is essential to follow this instruction to promote optimal medication delivery and minimize adverse effects. Choice B is incorrect because etanercept can be taken with or without food, and it is not specifically indicated to be taken with food to reduce gastrointestinal upset. Choice C is incorrect as there is no specific association between etanercept and sunlight exposure. Choice D is incorrect because while it is important to notify the healthcare provider of signs of infection, this is not the primary instruction related to the administration of etanercept.

5. A client with type 2 diabetes mellitus is prescribed dulaglutide. The nurse should monitor for which potential adverse effect?

• A. Nausea
• B. Hypoglycemia
• C. Hyperglycemia
• D. Pancreatitis

Correct answer: A

Rationale: The correct answer is 'Nausea.' Dulaglutide, a medication commonly used in the management of type 2 diabetes, can lead to gastrointestinal side effects such as nausea. While hypoglycemia and hyperglycemia are potential concerns in diabetes management, they are not typically associated with dulaglutide use. Pancreatitis is a serious adverse effect of some diabetes medications, but it is not a common side effect of dulaglutide.

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