Nursing Elites

1. A client has a new prescription for Verapamil to treat angina. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Muscle pain
• B. Dry cough
• C. Peripheral edema
• D. Increased urination

Correct answer: C

Rationale: Verapamil, a calcium channel blocker, can cause peripheral edema due to vasodilation. Clients should monitor for this adverse effect characterized by swelling in the extremities. Muscle pain (choice A) is not a common adverse effect of Verapamil. Dry cough (choice B) is more commonly associated with ACE inhibitors. Increased urination (choice D) is not a typical adverse effect of Verapamil. Therefore, the correct answer is monitoring for peripheral edema.

2. A healthcare provider is educating a group of new parents about immunizations. The provider should instruct the parents that the series for which of the following vaccines is completed prior to the first birthday?

• A. Pneumococcal conjugate vaccine
• B. Meningococcal conjugate vaccine
• C. Varicella vaccine
• D. Rotavirus vaccine

Correct answer: D

Rationale: The correct answer is D, Rotavirus vaccine. The series for the Rotavirus vaccine is completed prior to the first birthday as it is only administered to infants less than 8 months of age. This vaccine provides protection against severe diarrhea and vomiting caused by rotavirus infection, which is common in infants and young children. Choices A, B, and C are incorrect because the series for these vaccines extends beyond the first birthday. Pneumococcal conjugate vaccine and Meningococcal conjugate vaccine are typically given in multiple doses up to 2 years of age, while the Varicella vaccine is usually administered between 12 to 15 months of age.

3. A client has a new prescription for Pancrelipase for chronic pancreatitis. Which of the following instructions should be included by the nurse?

• A. Take the medication with meals and snacks.
• B. Chew the tablet thoroughly before swallowing.
• C. Take the medication 1 hour before meals.
• D. Expect the stool to be yellow.

Correct answer: A

Rationale: The correct instruction for taking Pancrelipase is to take it with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This helps optimize the effectiveness of the medication in managing chronic pancreatitis. Choice B is incorrect because Pancrelipase should not be chewed but swallowed whole. Choice C is incorrect as the medication should be taken with meals. Choice D is incorrect because while Pancrelipase can cause stool changes, yellow stool is not an expected outcome.

4. A client is starting Simvastatin. Which of the following information should be included in the teaching?

• A. Take this medication in the evening.
• B. Change positions slowly when rising from a chair.
• C. Maintain a steady intake of green leafy vegetables.
• D. Consume no more than 1 L/day of fluid.

Correct answer: A

Rationale: The correct answer is to take simvastatin in the evening. This timing is recommended because nighttime is when the most cholesterol is synthesized in the body. By taking statin medications in the evening, it can enhance their effectiveness in reducing cholesterol levels.

5. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: The correct answer is B: Fever. Fever is a key symptom of serotonin syndrome, a potentially life-threatening condition that can occur with the use of serotonergic medications like Sertraline. Serotonin syndrome is characterized by a combination of symptoms, including fever, agitation, rapid heartbeat, sweating, shivering, tremors, and in severe cases, it can lead to seizures, coma, and even death. Bruising (Choice A), abdominal pain (Choice C), and rash (Choice D) are not typically associated with serotonin syndrome. Therefore, the nurse should be vigilant in monitoring for fever as an early sign of serotonin syndrome in clients taking Sertraline.

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