Nursing Elites

1. A client has a prescription for sertraline to treat depression. Which of the following statements by the client indicates an understanding of the medication treatment plan?

• A. I will start feeling better immediately after starting the medication
• B. I can expect to urinate frequently while on this medication
• C. I understand I may experience difficulty sleeping on this medication
• D. I should decrease my sodium intake while on this medication

Correct answer: C

Rationale: The correct answer is C. Difficulty sleeping is a common side effect of sertraline, an SSRI used to treat depression. Clients should be educated to expect this, especially during the early stages of treatment. Choice A is incorrect because sertraline may take a few weeks to show its full effect. Choice B is incorrect as increased urination is not a common side effect of sertraline. Choice D is unrelated to the side effects or management of sertraline.

2. A nurse is developing a plan of care for a newborn who has hyperbilirubinemia and a prescription for phototherapy. Which of the following interventions should the nurse include?

• A. Check the newborn's temperature every 4 hours
• B. Apply moisturizing lotion to the newborn's skin every 4 hours
• C. Give the newborn 1 oz of glucose water every 4 hours
• D. Reposition the newborn every 2 to 3 hours

Correct answer: D

Rationale: Repositioning the newborn every 2 to 3 hours during phototherapy is important to expose all areas of the skin to light and facilitate the breakdown of bilirubin. Checking the newborn's temperature is important, but it should be done more frequently, such as every 4 hours, to monitor for any signs of overheating or hypothermia. Applying moisturizing lotion is not indicated during phototherapy as it may interfere with the treatment. Giving glucose water is not necessary for the management of hyperbilirubinemia.

3. A healthcare professional is assessing a client with a history of heart disease. Which of the following findings should the healthcare professional monitor?

• A. Blood pressure
• B. Weight
• C. Heart rhythm
• D. All of the above

Correct answer: D

Rationale: Monitoring blood pressure, weight, and heart rhythm is crucial in clients with a history of heart disease as these parameters can indicate changes in the cardiovascular status. Changes in blood pressure can signify heart strain, weight fluctuations can be related to fluid retention or heart failure, and irregular heart rhythm can indicate arrhythmias or other cardiac issues. Monitoring all these parameters comprehensively allows for early detection of potential complications and timely intervention. Therefore, selecting 'All of the above' is the correct choice as it encompasses all the essential parameters for monitoring in clients with heart disease. Choices A, B, and C are incorrect as monitoring only one or two of these parameters may lead to missing important changes in the client's condition.

4. A healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD) receiving oxygen therapy. Which of the following findings indicates oxygen toxicity?

• A. Oxygen saturation 94%
• B. Decreased respiratory rate
• C. Wheezing
• D. Peripheral cyanosis

Correct answer: B

Rationale: The correct answer is B: Decreased respiratory rate. In clients with COPD, especially when receiving oxygen therapy, a decreased respiratory rate is indicative of oxygen toxicity. This occurs because their respiratory drive is often dependent on low oxygen levels. Oxygen saturation of 94% is within an acceptable range and does not necessarily indicate oxygen toxicity. Wheezing is more commonly associated with airway narrowing or constriction, while peripheral cyanosis is a sign of decreased oxygen levels in the peripheral tissues, not oxygen toxicity.

5. When caring for a client prescribed azithromycin, what should the nurse monitor?

• A. Liver function
• B. Signs of diarrhea
• C. Blood glucose levels
• D. Serum electrolytes

Correct answer: B

Rationale: The correct answer is to monitor signs of diarrhea when a client is prescribed azithromycin. Azithromycin is known to cause gastrointestinal side effects, particularly diarrhea. Monitoring for diarrhea is crucial to assess the client's response to the medication and to prevent complications such as dehydration. Monitoring liver function (choice A), blood glucose levels (choice C), and serum electrolytes (choice D) are not typically indicated specifically for clients prescribed azithromycin unless there are other specific reasons or conditions that warrant such monitoring.

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