Nursing Elites

1. A client has a new prescription for Amlodipine. Which of the following side effects should the client monitor for and report?

• A. Swelling of the ankles.
• B. Increased urination.
• C. Persistent cough.
• D. Dark-colored urine.

Correct answer: A

Rationale: Corrected Rationale: Amlodipine, a calcium channel blocker, can cause peripheral edema (swelling of the ankles) as a side effect. This occurs due to the dilation of blood vessels and increased fluid retention. It is important for the client to monitor for ankle swelling as it could indicate a potential adverse reaction to the medication. Reporting this side effect to the healthcare provider is crucial to ensure appropriate management and potential adjustment of the treatment plan.\n Choice B, increased urination, is not a common side effect of Amlodipine. Choice C, persistent cough, is more commonly associated with ACE inhibitors rather than calcium channel blockers like Amlodipine. Choice D, dark-colored urine, is not a typical side effect of Amlodipine and is not something the client should specifically monitor for and report while taking this medication.

2. A healthcare professional is reviewing the medication list of a client who has a new prescription for Digoxin to treat heart failure. Which of the following medications places the client at risk for Digoxin toxicity?

• A. Spironolactone
• B. Calcium channel blockers
• C. Loop diuretics
• D. ACE inhibitors

Correct answer: C

Rationale: Loop diuretics, such as Furosemide, can increase the risk of Digoxin toxicity by causing hypokalemia. Hypokalemia enhances the toxic effects of Digoxin on the heart, leading to an increased risk of Digoxin toxicity. Spironolactone (Choice A) is less likely to cause hypokalemia and does not significantly increase the risk of Digoxin toxicity. Calcium channel blockers (Choice B) and ACE inhibitors (Choice D) do not directly increase the risk of Digoxin toxicity through hypokalemia; therefore, they are not the medications that place the client at risk for Digoxin toxicity.

3. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

4. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypertension
• C. Bone marrow suppression
• D. Constipation

Correct answer: C

Rationale: The correct answer is bone marrow suppression (Choice C). Methotrexate can lead to bone marrow suppression, resulting in adverse effects such as anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is essential to prevent complications and adjust treatment as needed. Choices A, B, and D are incorrect. Insomnia, hypertension, and constipation are not typically associated with methotrexate use in the treatment of Rheumatoid Arthritis.

5. A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This situation can result in increased drug levels in the body, causing drowsiness and other side effects. Adjusting the dosage of the hypnotic medication may be necessary to prevent such adverse effects in older adult clients. Choice A, reduced cardiac function, is not directly related to the metabolism of the medication and is unlikely to cause drowsiness. Choice B, first-pass effect, refers to the initial metabolism of a drug in the liver before it enters circulation, but it is not the cause of drowsiness in this scenario. Choice D, increased gastric motility, does not play a significant role in the metabolism of the medication and is not a likely cause of the client's drowsiness.

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