Nursing Elites

1. What instruction should the nurse include in the teaching plan for a client prescribed etanercept for rheumatoid arthritis?

• A. Rotate injection sites to prevent irritation.
• B. Take this medication with food to reduce gastrointestinal upset.
• C. Avoid sunlight exposure while on this medication.
• D. Notify the healthcare provider of any signs of infection.

Correct answer: A

Rationale: The correct instruction for a client prescribed etanercept is to rotate injection sites to prevent irritation and ensure proper absorption. Changing sites will help prevent skin irritation and ensure that the medication is absorbed effectively. This practice also reduces the risk of injection site reactions and discomfort. It is essential to follow this instruction to promote optimal medication delivery and minimize adverse effects. Choice B is incorrect because etanercept can be taken with or without food, and it is not specifically indicated to be taken with food to reduce gastrointestinal upset. Choice C is incorrect as there is no specific association between etanercept and sunlight exposure. Choice D is incorrect because while it is important to notify the healthcare provider of signs of infection, this is not the primary instruction related to the administration of etanercept.

2. A practical nurse (PN) is preparing to administer enoxaparin to a client. What is the most important action for the PN to take before administering this medication?

• A. Assess the client's blood pressure.
• B. Check the client's platelet count.
• C. Monitor the client's urine output.
• D. Review the client's blood glucose level.

Correct answer: B

Rationale: The correct answer is to check the client's platelet count. Enoxaparin can lead to thrombocytopenia (low platelet count), which can increase the risk of bleeding. Therefore, assessing the platelet count before administering enoxaparin is crucial to ensure that it is within a safe range. Assessing the client's blood pressure (Choice A) is not directly related to enoxaparin administration. Monitoring urine output (Choice C) and reviewing blood glucose levels (Choice D) are not essential actions before administering enoxaparin.

3. A client with a history of myocardial infarction is prescribed atorvastatin. The nurse should monitor the client for which potential adverse effect?

• A. Liver damage
• B. Kidney damage
• C. Muscle pain
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Muscle pain. Atorvastatin can cause muscle pain, which may indicate rhabdomyolysis, a serious adverse effect. Rhabdomyolysis is a condition where muscle breakdown releases a protein (myoglobin) into the bloodstream, potentially leading to kidney damage. Liver damage (choice A) is a less common side effect of atorvastatin compared to muscle pain. Kidney damage (choice B) is not a direct adverse effect of atorvastatin but can occur indirectly if rhabdomyolysis is severe. Increased appetite (choice D) is not a known adverse effect of atorvastatin.

4. A client with epilepsy is prescribed lamotrigine. The nurse should monitor for which potential side effect?

• A. Drowsiness
• B. Nausea and vomiting
• C. Skin rash
• D. Dizziness

Correct answer: C

Rationale: When a client is prescribed lamotrigine, the nurse should closely monitor for the potential side effect of skin rash. Lamotrigine is known to cause skin rashes, which can be mild or severe, indicating a serious adverse reaction like Stevens-Johnson syndrome. Monitoring for skin rash is crucial to detect any signs of severe allergic reactions early and prevent further complications. Choices A, B, and D are incorrect as drowsiness, nausea and vomiting, and dizziness are not typically associated with lamotrigine use. While dizziness can be a side effect of some antiepileptic medications, it is not a common side effect of lamotrigine.

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

• A. Weight gain
• B. Hair loss
• C. Insomnia
• D. Tremors

Correct answer: A

Rationale: When a client with bipolar disorder is prescribed quetiapine, the nurse should monitor for weight gain as a potential adverse effect. Quetiapine is known to commonly cause weight gain, which can have implications for the client's overall health. Regular monitoring of weight can help in early detection and management of this side effect.

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