Nursing Elites

1. A client is prescribed atorvastatin. The practical nurse should monitor the client for which potential adverse effect?

• A. Muscle pain and weakness
• B. Headache
• C. Hepatotoxicity
• D. Gastrointestinal bleeding

Correct answer: A

Rationale: The correct answer is A: Muscle pain and weakness. Atorvastatin is known to potentially cause muscle pain and weakness, which could indicate muscle damage or rhabdomyolysis. This adverse effect should be closely monitored by the practical nurse to ensure early detection and appropriate management. Choices B, C, and D are incorrect because they are not typically associated with atorvastatin use. Headache is a less common side effect, hepatotoxicity is rare but serious, and gastrointestinal bleeding is not a common adverse effect of atorvastatin.

2. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. The nurse should instruct the client to report which potential side effect?

• A. Dry mouth
• B. Blurred vision
• C. Nausea
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Dry mouth. Tiotropium, a commonly prescribed medication for COPD, can cause dry mouth as a side effect. While it may not be severe, clients should report it if it becomes bothersome. Dry mouth is a common side effect of tiotropium due to its anticholinergic properties. Blurred vision, nausea, and tachycardia are not typically associated with tiotropium use in the context of COPD.

3. What class of laxative would the nurse recommend to a patient asking about the best way to prevent constipation?

• A. Stimulant laxatives
• B. Bulk-forming laxatives
• C. Emollient laxatives
• D. Hyperosmotic laxatives

Correct answer: B

Rationale: The correct answer is B: Bulk-forming laxatives. These laxatives are recommended to prevent constipation because they work by absorbing liquid in the intestines, forming a bulky, soft stool that is easier to pass. They are safe and considered the most natural option. Stimulant laxatives (choice A) work by promoting bowel movements through intestinal contractions and are more suitable for treating occasional constipation rather than preventing it. Emollient laxatives (choice C) soften the stool by increasing the incorporation of water into the feces and are more suitable for patients who need to avoid straining during defecation. Hyperosmotic laxatives (choice D) work by drawing water into the intestine through osmosis and are typically used for more severe cases of constipation, not for prevention.

4. The healthcare provider has prescribed an influenza vaccine for a 74-year-old client before discharge. Which client condition would prompt the practical nurse to consult with the charge nurse rather than administer the vaccine?

• A. History of congestive heart failure
• B. History of an egg allergy
• C. History of pneumococcal vaccination
• D. History of end-stage renal disease

Correct answer: B

Rationale: The correct answer is B: History of an egg allergy. The influenza vaccine may contain a small amount of egg protein. According to the CDC, individuals with a severe allergy to any component of the vaccine, including egg protein, should not receive the influenza vaccine. Therefore, if the client has a history of an allergy to eggs, the practical nurse should not administer the vaccine and consult with the charge nurse for further guidance, as it is a contraindication. The other conditions listed do not require consultation before administering the influenza vaccine.

5. A client has metoprolol prescribed. The nurse should reinforce instructions that this medication has which potential adverse effect?

• A. Anxiety
• B. Tachycardia
• C. Sexual dysfunction
• D. Acute renal failure

Correct answer: C

Rationale: The correct answer is C: Sexual dysfunction. Metoprolol, a beta-blocker, can cause sexual dysfunction as an adverse effect. It is important for the nurse to educate the client about this potential side effect. Choice A is incorrect because metoprolol can cause depression, not anxiety. Choice B is incorrect as tachycardia is not an adverse effect of metoprolol; instead, it can lead to bradycardia. Choice D is incorrect because acute renal failure is not typically associated with the use of beta-blockers.

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