Nursing Elites

1. A client with a history of atrial fibrillation is prescribed warfarin. The nurse should monitor for which sign of potential bleeding?

• A. Elevated blood pressure
• B. Bruising
• C. Shortness of breath
• D. Nausea and vomiting

Correct answer: B

Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. Bruising is a common sign of potential bleeding in clients taking warfarin. Monitoring for bruising is essential as it can indicate a risk of bleeding that needs further assessment and management. Elevated blood pressure, shortness of breath, nausea, and vomiting are not direct signs of potential bleeding associated with warfarin therapy.

2. A client with a diagnosis of depression is prescribed escitalopram. Which statement by the client indicates the need for further teaching?

• A. I should take this medication in the morning with food.
• B. This medication may take 1 to 4 weeks to notice improvement in symptoms.
• C. I can stop taking this medication once I feel better.
• D. This medication might make me feel drowsy.

Correct answer: C

Rationale: It is crucial for clients to understand that they should not discontinue escitalopram abruptly, even if they start feeling better. Stopping the medication suddenly can lead to withdrawal symptoms or a relapse of depression. It is essential to complete the full course of treatment as prescribed by the healthcare provider to ensure the best outcomes and prevent potential complications.

3. Which assessment finding indicates that the expected outcome of administering donepezil to a client with Alzheimer's disease has been accomplished?

• A. Increased muscle strength and tone
• B. Fewer episodes of urinary incontinence
• C. Decreased confusion and improved mood
• D. Reversal of the disease process as evidenced by increased functioning

Correct answer: C

Rationale: The correct answer is C. Donepezil is a medication used for individuals with Alzheimer's disease. Its mechanism of action involves increasing acetylcholine levels by inhibiting its breakdown, which benefits cognitive function. The expected outcome of administering donepezil is a decrease in confusion and an improvement in mood due to the medication's impact on neurotransmitters. Choices A, B, and D are incorrect because donepezil does not primarily target muscle strength, urinary incontinence, or disease reversal; instead, it aims to slow down the progression of cognitive decline in Alzheimer's disease.

4. A client with chronic pain is prescribed oxycodone. What instruction should the practical nurse (PN) include in the client's teaching plan?

• A. Take the medication with meals to avoid gastrointestinal upset.
• B. Avoid taking the medication with alcohol.
• C. Increase fluid intake to avoid constipation.
• D. Report any signs of respiratory depression to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking oxycodone with alcohol. Mixing oxycodone with alcohol can lead to serious side effects, including respiratory depression. Taking the medication with meals may not always be necessary, and instructions about fluid intake to avoid constipation are important but not the priority when considering the immediate risks associated with oxycodone. While reporting signs of respiratory depression is crucial, preventing it by avoiding alcohol is key in the client's safety.

5. A client with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. The nurse should assess the client for which potential side effect?

• A. Nausea
• B. Dry mouth
• C. Cough
• D. Palpitations

Correct answer: B

Rationale: The correct answer is B: Dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. Anticholinergic medications like ipratropium can lead to decreased salivary flow, resulting in dry mouth. Choices A, C, and D are incorrect because nausea, cough, and palpitations are not commonly associated with ipratropium use.

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