Nursing Elites

1. A client is prescribed verapamil for hypertension. The nurse should monitor the client for which common adverse effect?

• A. Constipation
• B. Headache
• C. Muscle cramping
• D. Fatigue

Correct answer: A

Rationale: Verapamil, a calcium channel blocker commonly used for hypertension, is known to cause constipation as a frequent adverse effect. This occurs due to its effects on smooth muscle relaxation in the gastrointestinal tract, leading to decreased motility. Headache, muscle cramping, and fatigue are not typically associated with verapamil use and are less common side effects. Therefore, the nurse should closely monitor the client for symptoms of constipation when administering verapamil.

2. A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?

• A. Increased risk of infection
• B. Bone marrow suppression
• C. Hair loss
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.

3. A 67-year-old client is discharged from the hospital with a prescription for digoxin 0.25 mg daily. Which instruction by the practical nurse (PN) is correct?

• A. Take the medication in the morning before getting out of bed.
• B. Do not take the medication if the heartbeat is irregular or slow.
• C. Expect some vision changes due to the medication.
• D. Increase intake of foods rich in potassium.

Correct answer: B

Rationale: The correct instruction for a client taking digoxin is not to take the medication if the heartbeat is irregular or slow. Digoxin can affect the heart rhythm, so it is crucial to monitor the pulse rate. In case of irregular or slow heartbeats, the medication should be withheld, and the healthcare provider should be consulted. This step is necessary to prevent potential complications associated with digoxin therapy. Choices A, C, and D are incorrect. Taking digoxin in the morning before getting out of bed is not a specific requirement. Vision changes are not a common side effect of digoxin. While digoxin can affect potassium levels, it is not advised to increase potassium intake without healthcare provider guidance.

4. The practical nurse administered 15 units of NPH insulin subcutaneously to a client before they consumed their breakfast at 7:30 AM. At what time is the client at an increased risk for a hypoglycemic reaction?

• A. 8:30 to 11:30 AM
• B. 3:30 to 7:30 PM
• C. 9:30 PM to midnight
• D. 1:00 to 5:00 AM

Correct answer: B

Rationale: NPH insulin, an intermediate-acting type, peaks approximately 8 to 12 hours after subcutaneous administration. Considering this, the client is most likely to experience a hypoglycemic reaction between 3:30 and 7:30 PM, making option B the correct answer. Choices A, C, and D are incorrect because they fall outside the peak time for a hypoglycemic reaction after administering NPH insulin.

5. The healthcare provider is assessing the effectiveness of the drug amiodarone. Which client statement best indicates that the drug has been effective?

• A. I have not had as many spells of angina.
• B. I have not had as much swelling in my ankles lately.
• C. My doctor told me my cholesterol levels were improving with each visit.
• D. I do not notice as many irregular heartbeats as before I started taking this medication.

Correct answer: D

Rationale: The correct answer is option D. The effectiveness of amiodarone is best assessed by a reduction in irregular heartbeats since it is primarily used to treat ventricular dysrhythmias. This drug's main purpose is to control irregular heart rhythms, so a decrease in irregular heartbeats indicates its effectiveness. Options A, B, and C are incorrect because amiodarone is not primarily used to address angina, ankle swelling, or cholesterol levels, so improvements in these areas do not directly reflect the drug's effectiveness.

Similar Questions