Nursing Elites

1. A client with chronic kidney disease is prescribed sevelamer carbonate. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed sevelamer carbonate, the nurse should monitor for hypercalcemia as a potential side effect. Sevelamer carbonate can bind to dietary calcium and impair its absorption, potentially leading to elevated calcium levels in the blood. Monitoring calcium levels is crucial to detect and manage hypercalcemia promptly. Hypocalcemia (choice B) is incorrect because sevelamer carbonate's action is more likely to cause elevated calcium levels. Hyperkalemia (choice C) and hypokalemia (choice D) are related to potassium levels and are not typically associated with sevelamer carbonate use.

2. A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?

• A. The client is experiencing vision and hearing loss.
• B. The client has an erection lasting longer than 4 hours.
• C. The client is complaining of nasal congestion.
• D. The client is complaining of feeling flushed.

Correct answer: A

Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications. Choices B, C, and D are incorrect because an erection lasting more than 2 hours (not 4 hours as stated in choice B) is a critical adverse effect that warrants immediate medical attention. Nasal congestion (choice C) and feeling flushed (choice D) are common side effects of sildenafil and typically do not necessitate immediate discontinuation of the medication or emergency intervention.

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

• A. Weight gain
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Weight gain. When a client is prescribed lurasidone, monitoring for weight gain is essential as lurasidone can cause this side effect. Patients on lurasidone should have their weight monitored regularly to detect any changes that may occur. Options B, C, and D are not typically associated with lurasidone use, making them less likely to be a direct side effect of this medication.

4. A client with a history of stroke is prescribed warfarin. The nurse should monitor for which potential side effect?

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Bleeding. Warfarin is an anticoagulant medication that works by thinning the blood. One of the potential side effects of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as unusual bruising, blood in the urine or stool, or prolonged bleeding from cuts or gums. Prompt recognition and management of bleeding are essential to prevent complications. Choices B, C, and D are incorrect as weight gain, headache, and dizziness are not common side effects of warfarin. Monitoring for bleeding is a priority due to the anticoagulant properties of warfarin.

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

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

Correct answer: A

Rationale: The correct answer is 'Nausea.' Dulaglutide, a medication commonly used in the management of type 2 diabetes, can lead to gastrointestinal side effects such as nausea. While hypoglycemia and hyperglycemia are potential concerns in diabetes management, they are not typically associated with dulaglutide use. Pancreatitis is a serious adverse effect of some diabetes medications, but it is not a common side effect of dulaglutide.

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