Nursing Elites

1. A client receiving enalapril reports a persistent dry cough. The nurse should explain that this side effect is related to which medication action?

• A. It reduces the production of angiotensin II.
• B. It increases the production of angiotensin II.
• C. It causes increased production of bradykinin.
• D. It increases the production of aldosterone.

Correct answer: C

Rationale: The correct answer is C. Enalapril, an ACE inhibitor, inhibits the conversion of angiotensin I to angiotensin II, leading to increased levels of bradykinin. The accumulation of bradykinin is responsible for the persistent dry cough associated with ACE inhibitors like enalapril. Choices A, B, and D are incorrect because enalapril does not directly affect the production of angiotensin II or aldosterone. Instead, it primarily impacts the renin-angiotensin-aldosterone system by inhibiting the conversion of angiotensin I to angiotensin II, leading to bradykinin accumulation.

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

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

Correct answer: A

Rationale: Corrected Rationale: Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor used in type 2 diabetes, has been associated with rare cases of pancreatitis. Therefore, the nurse should monitor for signs and symptoms of pancreatitis such as severe abdominal pain, nausea, and vomiting. While hypoglycemia is a potential adverse effect of some diabetes medications, it is less common with sitagliptin. Hyperglycemia is the condition being treated and is not an expected adverse effect of sitagliptin.

3. 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.

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

• A. Genital infections
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Genital infections. Dapagliflozin, a medication used in diabetes mellitus type 2, is associated with an increased risk of genital infections. Its mechanism of action involves promoting glucose excretion through the urine, creating a favorable environment for microbial growth in the genital area. Monitoring for genital infections is crucial when a client is prescribed dapagliflozin. Hypoglycemia (choice B) is not a common adverse effect of dapagliflozin since it does not directly lower blood glucose levels. Hyperglycemia (choice C) is also unlikely as dapagliflozin is intended to help lower blood glucose levels. Nausea (choice D) is a less common side effect of dapagliflozin compared to genital infections.

5. A client with rheumatoid arthritis is prescribed tofacitinib. What should the nurse include in the client's teaching plan?

• A. Avoid live vaccines while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Report any signs of infection to the healthcare provider.
• D. Avoid sunlight while taking this medication.

Correct answer: A

Rationale: Tofacitinib is an immunosuppressive medication used in rheumatoid arthritis. Patients taking tofacitinib should avoid live vaccines because the medication can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent any complications related to live vaccines during their treatment.

Similar Questions