Nursing Elites

1. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

2. A client is receiving treatment with etoposide. Which of the following findings should the nurse monitor?

• A. Hypotension
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypertension

Correct answer: A

Rationale: Etoposide is associated with hypotension as a common adverse effect. Therefore, the nurse should closely monitor the client for signs and symptoms of hypotension while receiving this medication, such as dizziness, light-headedness, or low blood pressure readings. Prompt recognition and management of hypotension can help prevent complications and ensure the client's safety during treatment with etoposide.

3. A patient is being discharged with a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bedtime.
• B. Monitor for increased blood pressure.
• C. Take the medication with food.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct instruction the nurse should include is to monitor for leg cramps. Leg cramps can be a sign of hypokalemia, which is a potential adverse effect of Hydrochlorothiazide. By monitoring for leg cramps, the patient can detect signs of low potassium levels and report them to the healthcare provider promptly. This proactive approach helps prevent complications associated with hypokalemia. The other options are incorrect because taking Hydrochlorothiazide before bedtime or with food is not specific to the medication's adverse effects. Monitoring for increased blood pressure is not typically a common adverse effect of this medication.

4. A client has a prescription for Bethanechol to treat urinary retention. Which of the following findings is a manifestation of muscarinic stimulation?

• A. Dry mouth
• B. Hypertension
• C. Excessive perspiration
• D. Fecal impaction

Correct answer: C

Rationale: The correct answer is C: Excessive perspiration. Bethanechol is a muscarinic agonist that stimulates muscarinic receptors. Activation of muscarinic receptors can lead to excessive perspiration (diaphoresis) due to increased cholinergic activity, affecting sweat glands. Dry mouth, hypertension, and fecal impaction are not typically associated with muscarinic stimulation. Dry mouth is more commonly associated with anticholinergic medications, hypertension can be a result of alpha-adrenergic stimulation, and fecal impaction is not a direct effect of muscarinic receptor activation.

5. When a client is starting long-term oral prednisone for chronic asthma, what adverse effect should the nurse instruct the client to monitor for?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is a common adverse effect of oral prednisone due to sodium and water retention, which can lead to fluid retention. Monitoring weight changes is important as it helps in early identification of this adverse effect, enabling timely interventions to manage it. Choice B, nervousness, is not typically associated with oral prednisone use. Bradycardia (Choice C) is unlikely as prednisone usually causes tachycardia or increased heart rate. Constipation (Choice D) is not a common adverse effect of prednisone compared to weight gain.

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