Nursing Elites

1. A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?

• A. Increased risk of infection
• B. Bone marrow suppression
• C. Hair loss
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.

2. A client with a diagnosis of depression is prescribed fluoxetine. Which statement by the client indicates the need for further teaching?

• A. I should take this medication in the morning with food.
• B. It may take 1 to 4 weeks to notice improvement in symptoms.
• C. I can stop taking this medication once I feel better.
• D. This medication might make me feel drowsy.

Correct answer: C

Rationale: The correct answer is C. Clients prescribed fluoxetine should not stop taking the medication once they feel better without consulting their healthcare provider. It is essential to complete the full course of treatment as directed by the healthcare provider to prevent relapse or potential worsening of symptoms. Abruptly stopping fluoxetine can lead to withdrawal symptoms and may not effectively manage the condition. Therefore, it is crucial for clients to follow the healthcare provider's guidance regarding the duration of treatment with fluoxetine.

3. A client diagnosed with angina has been prescribed nitrate isosorbide dinitrate. Which instruction should the practical nurse reinforce in this client's teaching?

• A. Discontinue the medication if dizziness occurs.
• B. Avoid getting up quickly. Always rise slowly.
• C. Take the medication with or without food.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction that the practical nurse should reinforce with a client prescribed nitrate isosorbide dinitrate is to avoid getting up quickly and to rise slowly. Nitrates can cause orthostatic hypotension, a sudden drop in blood pressure when changing positions. By rising slowly, the client can prevent the occurrence of orthostatic hypotension and its associated symptoms. Choices A, C, and D are incorrect because discontinuing the medication without consulting a healthcare provider can be dangerous, taking the medication with or without food does not impact its effectiveness, and increasing potassium intake is not directly related to the use of nitrate isosorbide dinitrate.

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

• A. Constipation
• B. Diarrhea
• C. Headache
• D. Hypotension

Correct answer: A

Rationale: Verapamil, a calcium channel blocker, can commonly cause constipation due to its effects on smooth muscle relaxation in the gastrointestinal tract. Therefore, monitoring for constipation is important when a client is prescribed verapamil.

5. A client is prescribed lisinopril for hypertension. What potential adverse effect should the practical nurse (PN) instruct the client to monitor for?

• A. Persistent cough
• B. Constipation
• C. Increased appetite
• D. Dry skin

Correct answer: A

Rationale: Corrected Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. This cough is distinctive and different from other causes of cough. It is essential for the client to be aware of this potential side effect as it can indicate a serious issue. Instructing the client to monitor for a persistent cough and report it to the healthcare provider promptly is crucial to ensure timely intervention and management. Choices B, C, and D are incorrect as constipation, increased appetite, and dry skin are not commonly associated with lisinopril use for hypertension. Therefore, the practical nurse should focus on educating the client about monitoring and reporting a persistent cough.

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