Nursing Elites

1. 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. Methotrexate can lead to bone marrow suppression, resulting in anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is crucial to prevent complications. Insomnia (choice A), hypertension (choice B), and constipation (choice D) are not typically associated with methotrexate use for Rheumatoid Arthritis.

2. A client is taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication?

• A. Increased TSH level
• B. Decreased ALT level
• C. Hypoglycemia
• D. Hyperlipidemia

Correct answer: D

Rationale: The correct answer is D: Hyperlipidemia. Ritonavir, a protease inhibitor used in HIV treatment, can lead to hyperlipidemia, characterized by increased cholesterol and triglyceride levels. Monitoring lipid levels is crucial to identify and manage this potential adverse effect. Choices A, B, and C are incorrect because Ritonavir is not known to cause an increased TSH level, decreased ALT level, or hypoglycemia as adverse effects.

3. A healthcare professional is preparing to administer vancomycin to a client. The professional should monitor for which of the following adverse effects?

• A. Nephrotoxicity
• B. Hepatotoxicity
• C. Red Man Syndrome
• D. Diarrhea

Correct answer: C

Rationale: Red Man Syndrome is a common adverse effect of vancomycin characterized by flushing and rash. It is not related to nephrotoxicity, hepatotoxicity, or diarrhea. Monitoring for this reaction allows for prompt intervention to prevent severe complications.

4. A client is receiving discharge instructions for a new prescription of Warfarin. Which of the following over-the-counter medications should the client be instructed to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. Patients on Warfarin should avoid NSAIDs like Ibuprofen and opt for alternative pain relief options to prevent potential complications such as an increased risk of bleeding. Acetaminophen (Choice A), Diphenhydramine (Choice C), and Loratadine (Choice D) are not known to significantly interact with Warfarin in terms of bleeding risk and are generally considered safe to use alongside Warfarin.

5. A client who has been taking prednisone to treat asthma is advised to discontinue the medication. The client should be instructed to reduce the dose gradually to prevent which of the following adverse effects?

• A. Hyperglycemia
• B. Adrenocortical insufficiency
• C. Severe dehydration
• D. Rebound pulmonary congestion

Correct answer: B

Rationale: Abruptly stopping prednisone can result in adrenocortical insufficiency due to suppression of the adrenal glands. Gradually tapering the dose helps the body adjust and resume its natural cortisol production, preventing adrenal insufficiency. Choice A, hyperglycemia, is a possible adverse effect of prednisone, but it is not the primary reason for gradual tapering. Severe dehydration (Choice C) and rebound pulmonary congestion (Choice D) are not typically associated with discontinuing prednisone.

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