Nursing Elites

1. A client with a history of atrial fibrillation is prescribed diltiazem. The nurse should monitor for which potential side effect?

• A. Hypotension
• B. Tachycardia
• C. Headache
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Hypotension. Diltiazem is a calcium channel blocker that can cause hypotension by relaxing blood vessels and reducing blood pressure. Monitoring blood pressure is essential to detect and manage this potential side effect. Choices B, C, and D are incorrect because diltiazem typically does not cause tachycardia, headache, or hyperglycemia as common side effects.

2. Escitalopram is prescribed for a 16-year-old adolescent client who is clinically depressed. Five days later, the parent tells the practical nurse (PN) that the drug is not working because their child is not feeling any better. Which explanation should the PN provide?

• A. It takes 1 to 4 weeks for antidepressant medications to become effective.
• B. The dosage may need to be increased; I will contact your health care provider.
• C. Depression is difficult to treat with drugs alone. Therapy sessions would enhance their effectiveness.
• D. Based on your child's response to this drug, the health care provider is reviewing your medication regimen.

Correct answer: A

Rationale: Antidepressant medications typically require 1 to 4 weeks to reach their full therapeutic effect. It is crucial to educate the family that during the initial week of treatment, the child may experience heightened anxiety. Therefore, it is important to wait for the medication to take its full course before assessing its effectiveness.

3. A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?

• A. Avoid using artificial tears because they decrease the efficacy of cyclosporine.
• B. Discontinue the use of both products if transient blurring occurs after administration.
• C. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
• D. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level.

Correct answer: C

Rationale: The correct answer is to allow a 15-minute interval between the administration of cyclosporine and artificial tears. Cyclosporine, an ophthalmic emulsion that increases tear production, can be used in conjunction with artificial tears as long as the products are administered 15 minutes apart. This interval helps to prevent any potential interactions between the two products and ensures optimal effectiveness of cyclosporine for treating dry eyes.

4. A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?

• A. Initiate a second intravenous access site
• B. Prepare to initiate cardiopulmonary resuscitation
• C. Determine the results of the drug toxicity screen
• D. Administer an additional dose of naloxone

Correct answer: D

Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.

5. A client with a diagnosis of generalized anxiety disorder is prescribed sertraline. The nurse should instruct the client that this medication may have which potential side effect?

• A. Nausea
• B. Drowsiness
• C. Insomnia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Nausea. Sertraline, a selective serotonin reuptake inhibitor (SSRI), is known to commonly cause gastrointestinal side effects such as nausea. It is recommended for clients to take sertraline with food to help minimize this potential side effect. Choice B, Drowsiness, is less commonly associated with sertraline use. Insomnia, choice C, is not a typical side effect of sertraline; in fact, it may help improve sleep in some individuals. Headache, choice D, is also not a common side effect of sertraline.

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