Nursing Elites

1. When a patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium, the nurse should monitor for potential side effects. The correct answer is dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. This side effect can impact the patient's oral health and comfort, requiring close monitoring and appropriate interventions.

• A. Dry mouth
• B. Tachycardia
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: Ipratropium is an anticholinergic medication commonly used in COPD. One of the most common side effects of anticholinergics is dry mouth due to the inhibition of salivary gland function. Tachycardia (Choice B) is not a typical side effect of ipratropium. Insomnia (Choice C) is also not a common side effect of this medication. Increased appetite (Choice D) is not associated with ipratropium use. Therefore, the correct side effect to monitor for in a patient prescribed ipratropium is dry mouth.

2. A client with schizophrenia is prescribed risperidone. Which statement by the client indicates the need for further teaching?

• A. I can stop taking this medication once I feel better.
• B. This medication may cause drowsiness.
• C. This medication might make me feel drowsy.
• D. I should avoid alcohol while taking this medication.

Correct answer: A

Rationale: Clients should not stop taking risperidone abruptly once they feel better without consulting their healthcare provider.

3. A client with a diagnosis of bipolar disorder is prescribed valproate. The nurse should monitor for which potential adverse effect?

• A. Weight gain
• B. Hair loss
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: A

Rationale: The correct answer is A: Weight gain. Valproate is known to cause weight gain as a common adverse effect. It is important for the nurse to monitor the client's weight regularly while on this medication to detect and address any changes that may occur.

4. A client who is in the rehabilitation facility with newly diagnosed Parkinson's disease (PD) has levodopa-carbidopa prescribed. During the care planning session for this client, the nurse discusses which aspects with the other members of the health care team? (Select all that apply.)

• A. Ask the dietician to avoid increasing the amounts of foods high in Vitamin B6.
• B. Lessening of tremors
• C. Remind others on the team that this medication will not relieve all symptoms of PD.
• D. Ask the evening shift nurses to give the last dose earlier in the day if the client has insomnia.

Correct answer: D

Rationale: Levodopa-carbidopa is a medication commonly used in the treatment of Parkinson's disease (PD). It can cause side effects such as hypotension with sudden position changes. To assist the client in managing this side effect, the physical therapy assistant can help avoid sudden position changes. Additionally, if insomnia occurs, adjusting the timing of the last dose earlier in the day can be beneficial. It is important to note that drowsiness can also be a side effect of the medication and should be reported to the nurse. Foods high in Vitamin B6 can interfere with the absorption of levodopa-carbidopa; hence, it is advisable to avoid increasing the consumption of such foods. Lastly, it is crucial to remind the team that while this medication helps alleviate symptoms like tremors, it may not relieve all symptoms of PD comprehensively.

5. A client is prescribed atorvastatin. The practical nurse should monitor the client for which potential adverse effect?

• A. Muscle pain and weakness
• B. Headache
• C. Hepatotoxicity
• D. Gastrointestinal bleeding

Correct answer: A

Rationale: The correct answer is A: Muscle pain and weakness. Atorvastatin is known to potentially cause muscle pain and weakness, which could indicate muscle damage or rhabdomyolysis. This adverse effect should be closely monitored by the practical nurse to ensure early detection and appropriate management. Choices B, C, and D are incorrect because they are not typically associated with atorvastatin use. Headache is a less common side effect, hepatotoxicity is rare but serious, and gastrointestinal bleeding is not a common adverse effect of atorvastatin.

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