Nursing Elites

1. When a client with a history of deep vein thrombosis is prescribed fondaparinux, the nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: Fondaparinux is an anticoagulant prescribed to prevent blood clots. Therefore, the nurse should monitor the client for an increased risk of bleeding, which is a potential adverse effect of this medication. Choices B, C, and D are incorrect because fondaparinux does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for signs of bleeding, such as unexplained bruising, bleeding gums, or blood in the urine or stool, is crucial when a client is on fondaparinux.

2. The nurse is preparing a client with chronic obstructive pulmonary disease, which medication should the nurse review with the client to manage this?

• A. Guaifenesin
• B. Prednisone
• C. Salmeterol
• D. Tiotropium

Correct answer: D

Rationale: Tiotropium is commonly used for COPD management.

3. Prior to administering an oral dose of methylprednisolone, what is most important for the nurse to do?

• A. Administer the medication with a glass of milk
• B. Notify the healthcare provider of the finding
• C. Begin tapering the drug dose per protocol
• D. Teach the clients about foods high in calcium

Correct answer: A

Rationale: Administering methylprednisolone with food or milk is important as it can help reduce gastrointestinal side effects associated with the medication. This practice is commonly recommended to minimize stomach upset and irritation that may occur when taking methylprednisolone on an empty stomach. Therefore, it is crucial for the nurse to provide the medication with a glass of milk to enhance patient comfort and adherence to the treatment regimen. Choice B is incorrect as there is no indication in the question stem that suggests a need to notify the healthcare provider before administering the medication with food or milk. Choice C is incorrect because tapering the drug dose per protocol is not the immediate action needed prior to administering the first dose of methylprednisolone. Choice D is irrelevant to the administration of methylprednisolone and not the most important action to take before giving the medication.

4. A client with a diagnosis of schizophrenia is prescribed ziprasidone. The nurse should monitor the client for which potential side effect?

• A. QT prolongation
• B. Weight gain
• C. Dry mouth
• D. Increased appetite

Correct answer: A

Rationale: The correct answer is A: QT prolongation. Ziprasidone is known to cause QT prolongation, which can potentially lead to serious cardiac issues. Monitoring the client's ECG is crucial to detect any changes and prevent adverse effects related to QT interval prolongation. Choices B, C, and D are incorrect because weight gain, dry mouth, and increased appetite are not commonly associated with ziprasidone. While weight gain can be a side effect of some antipsychotic medications, it is not a prominent side effect of ziprasidone. Dry mouth and increased appetite are also not typically linked to ziprasidone use.

5. A client with chronic heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an excess of potassium in the body, resulting in hyperkalemia. This side effect is important to monitor in clients taking spironolactone, especially those with chronic heart failure, as hyperkalemia can lead to serious cardiac complications.

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