Nursing Elites

1. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypotension
• C. Bleeding
• D. Constipation

Correct answer: C

Rationale: The correct answer is C: Bleeding. Clopidogrel is an antiplatelet medication that works by preventing platelets from sticking together and forming clots. Therefore, one of the main adverse effects of clopidogrel is an increased risk of bleeding. Insomnia (Choice A), hypotension (Choice B), and constipation (Choice D) are not commonly associated with clopidogrel use. Monitoring for signs of bleeding, such as easy bruising, petechiae, or prolonged bleeding from minor cuts, is crucial when a client is taking clopidogrel.

2. A client with gout is prescribed allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects?

• A. Nausea
• B. Metallic taste
• C. Fever
• D. Drowsiness

Correct answer: C

Rationale: The correct answer is C: Fever. Fever can indicate a serious hypersensitivity reaction to allopurinol, known as allopurinol hypersensitivity syndrome, which can be severe and even life-threatening. Nausea and drowsiness are common side effects of allopurinol but not necessarily indications to discontinue the medication. Metallic taste is not typically associated with allopurinol use. Therefore, the nurse should emphasize to the client the importance of reporting any signs of fever promptly for further evaluation and management.

3. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

• A. Hearing examination
• B. Glucose tolerance test
• C. Electrocardiogram
• D. Pulmonary function tests

Correct answer: C

Rationale: The correct answer is C: Electrocardiogram. Amitriptyline can cause cardiac arrhythmias, so an electrocardiogram is necessary before starting treatment. A hearing examination (choice A) is not required before initiating amitriptyline. A glucose tolerance test (choice B) is not indicated for starting this medication. Pulmonary function tests (choice D) are not necessary before initiating amitriptyline for depression.

4. When administering subcutaneous epinephrine for a client experiencing anaphylaxis, what adverse effect should the nurse monitor for?

• A. Hypotension
• B. Hyperthermia
• C. Hypoglycemia
• D. Tachycardia

Correct answer: D

Rationale: The correct adverse effect to monitor for when administering subcutaneous epinephrine for anaphylaxis is tachycardia. Epinephrine stimulates adrenergic receptors, leading to an increased heart rate (tachycardia). Hypotension (Choice A) is less likely due to the vasoconstrictive effects of epinephrine. Hyperthermia (Choice B) and hypoglycemia (Choice C) are not commonly associated with epinephrine administration for anaphylaxis.

5. A client with chronic kidney failure and an AV fistula for hemodialysis is prescribed epoetin alfa. Which of the following therapeutic effects should the nurse include in the teaching?

• A. Reduces blood pressure
• B. Inhibits clotting of fistula
• C. Promotes RBC production
• D. Stimulates growth of neutrophils

Correct answer: C

Rationale: The correct answer is C: Promotes RBC production. Epoetin alfa stimulates erythropoiesis (red blood cell production) to treat anemia associated with chronic kidney failure. This helps in increasing the hemoglobin levels and improving oxygen-carrying capacity. Choices A, B, and D are incorrect as epoetin alfa does not have direct effects on reducing blood pressure, inhibiting clotting of the fistula, or stimulating the growth of neutrophils.

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