Nursing Elites

1. A client with rheumatoid arthritis is prescribed hydroxychloroquine. What instruction should the nurse include in the client's teaching plan?

• A. Avoid sunlight exposure while taking this medication.
• B. Take this medication with food to reduce gastrointestinal upset.
• C. Report any signs of infection to the healthcare provider.
• D. Report any signs of vision changes to the healthcare provider.

Correct answer: D

Rationale: Hydroxychloroquine is known to cause vision changes, including retinopathy. Therefore, it is crucial for clients to report any vision changes promptly to their healthcare provider to prevent any potential ocular complications. While sunlight exposure should be limited due to photosensitivity, the key concern with hydroxychloroquine is the risk of vision changes, not gastrointestinal upset or infections.

2. A healthcare professional prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's heart rate is 48 beats/min, respirations are 16 breaths/min, and blood pressure is 150/90 mmHg.

• A. Administer the dose and monitor the client's blood pressure regularly
• B. Apply a telemetry monitor before administering the dose
• C. Assess for orthostatic hypotension before administering the dose
• D. Withhold the scheduled dose and notify the healthcare provider

Correct answer: D

Rationale: The client's low heart rate of 48 beats/min indicates bradycardia, a potential side effect of labetalol. Administering the dose in this case could further lower the heart rate, potentially causing adverse effects. Therefore, it is crucial to withhold the scheduled dose and notify the healthcare provider for further assessment and guidance. Choice A is incorrect because administering the dose without addressing the bradycardia can exacerbate the condition. Choice B is not relevant in this situation as telemetry monitoring is not the priority. Choice C is also not the priority in this case, as the focus should be on the client's bradycardia and the potential adverse effects of administering labetalol.

3. A client who is recovering from an appendectomy is receiving narcotics. Earlier, the nurse witnessed the client's family pushing the pain pump. What should the nurse implement?

• A. Check the client's level of consciousness
• B. Instruct the family not to push the button
• C. Stop the client's basal infusion
• D. Administer a narcotic reversal medication

Correct answer: B

Rationale: Instructing the family not to push the button is necessary to prevent the client from receiving an excessive amount of narcotics, ensuring the safe and appropriate use of the pain pump. Checking the client's level of consciousness may not address the issue of family members pushing the button. Stopping the client's basal infusion is not indicated unless there are specific medical reasons for doing so. Administering a narcotic reversal medication is not necessary at this point as the issue lies with inappropriate use rather than an overdose.

4. What instructions should the practical nurse (PN) review with a client diagnosed with vaginal trichomoniasis who is prescribed oral metronidazole?

• A. Avoid direct sunlight exposure and use a sunscreen product with SPF100.
• B. The client's sexual partner(s) should also be treated.
• C. Avoid vinegar or commercial product douches.
• D. Eliminate dairy products from the diet during treatment.

Correct answer: B

Rationale: The correct answer is B. The practical nurse should instruct the client that their sexual partner(s) should also be treated when dealing with vaginal trichomoniasis. This is crucial to prevent reinfection as sexual intercourse is the route of spread for this infection. Choices A, C, and D are incorrect. While avoiding direct sunlight exposure and using sunscreen is important for some medications, it is not specifically related to metronidazole treatment for trichomoniasis. Avoiding vinegar or commercial douches is a general recommendation for vaginal health and not specific to this infection. Eliminating dairy products from the diet is not a typical instruction for clients prescribed metronidazole for vaginal trichomoniasis.

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

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

Correct answer: A

Rationale: The correct answer is A: Rash. Lamotrigine can cause a rash, which may indicate a serious adverse effect like Stevens-Johnson syndrome. Monitoring for a rash is crucial in clients taking lamotrigine to promptly address any potential severe reactions.

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