Nursing Elites

1. A client with a diagnosis of generalized anxiety disorder is prescribed lorazepam. The client should be informed that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Lorazepam, a medication commonly used to treat anxiety disorders, can lead to drowsiness as a common side effect. It is important for clients to be aware of this potential effect, and they should be advised to avoid activities like driving until they understand how the medication affects them. Dry mouth, nausea, and headache are possible side effects of other medications but are less commonly associated with lorazepam.

2. A client is receiving metronidazole for Clostridium difficile pseudomembranous colitis. Which information should the nurse include in this client's medication teaching plan?

• A. Drink adequate water daily
• B. Take with food
• C. Avoid alcohol consumption
• D. Store medication in the refrigerator

Correct answer: C

Rationale: The correct information to include in the medication teaching plan for a client receiving metronidazole for Clostridium difficile pseudomembranous colitis is to avoid alcohol consumption. Metronidazole can cause a disulfiram-like reaction when combined with alcohol, leading to symptoms such as nausea, vomiting, flushing, and headache. Therefore, it is crucial for the client to abstain from alcohol while taking this medication to prevent adverse effects and ensure treatment effectiveness. Choices A, B, and D are incorrect. Drinking adequate water daily is a general health recommendation but not specific to metronidazole use. Taking with food is not necessary for metronidazole, and in fact, it is recommended to be taken on an empty stomach for better absorption. Storing the medication in the refrigerator is also incorrect, as metronidazole should be stored at room temperature.

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

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

Correct answer: A

Rationale: Exenatide, a medication commonly used in type 2 diabetes, is known to cause gastrointestinal side effects, such as nausea. Monitoring for nausea is essential as it can lead to decreased appetite and potential weight loss, affecting the nutritional status of the client. While hypoglycemia and hyperglycemia are important to monitor in diabetes management, they are not typically associated with exenatide use. Pancreatitis is a rare but serious adverse effect of exenatide, which requires immediate medical attention if suspected.

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 is prescribed lisinopril for hypertension. What potential adverse effect should the practical nurse (PN) instruct the client to monitor for?

• A. Persistent cough
• B. Constipation
• C. Increased appetite
• D. Dry skin

Correct answer: A

Rationale: Corrected Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. This cough is distinctive and different from other causes of cough. It is essential for the client to be aware of this potential side effect as it can indicate a serious issue. Instructing the client to monitor for a persistent cough and report it to the healthcare provider promptly is crucial to ensure timely intervention and management. Choices B, C, and D are incorrect as constipation, increased appetite, and dry skin are not commonly associated with lisinopril use for hypertension. Therefore, the practical nurse should focus on educating the client about monitoring and reporting a persistent cough.

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