Nursing Elites

1. A client with angina is seeking a prescription for sildenafil to manage erectile dysfunction. Which of the following medications is contraindicated with Sildenafil?

• A. Aspirin
• B. Isosorbide
• C. Clopidogrel
• D. Atorvastatin

Correct answer: B

Rationale: Isosorbide, an organic nitrate used for angina, is contraindicated with sildenafil due to the risk of fatal hypotension. Concurrent use of these medications can lead to severe hypotension. Patients are advised to avoid taking nitrate medications for 24 hours after using isosorbide to prevent this dangerous interaction.

2. A healthcare professional is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare professional should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders caused by certain medications affecting the central nervous system. These effects can include symptoms like tremors, rigidity, and bradykinesia. Medications like typical antipsychotics induce extrapyramidal effects by interfering with dopamine transmission in the central nervous system. Choices A, B, and D are incorrect as extrapyramidal effects are specifically related to the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

3. While providing teaching to a client with a new prescription for Enalapril, the nurse should instruct the client to report which of the following manifestations as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: The correct answer is 'B: Dry cough.' Enalapril is an ACE inhibitor known to cause a persistent dry cough as a common adverse effect. This cough should be reported to the healthcare provider for further evaluation, as it may indicate a potential issue with the medication that needs attention to ensure the client's well-being. Tremors (Choice A), drowsiness (Choice C), and hyperactivity (Choice D) are not typically associated with Enalapril use. Therefore, they are incorrect choices for this question.

4. A client is starting therapy with cisplatin. Which of the following findings should the nurse instruct the client to report?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: Tinnitus should be reported by the client as it can be indicative of ototoxicity, an adverse effect associated with cisplatin therapy. Ototoxicity can result in damage to the inner ear structures, leading to hearing problems. Therefore, prompt reporting of tinnitus is essential for early intervention and prevention of potential complications. Nausea, constipation, and weight gain are common side effects of cisplatin but are not typically indicative of serious complications requiring immediate reporting compared to tinnitus.

5. A client has a new prescription for Amiodarone. Which of the following instructions should the nurse include?

• A. Take this medication with meals.
• B. Avoid drinking grapefruit juice.
• C. Take this medication at bedtime.
• D. Increase your intake of sodium-rich foods.

Correct answer: B

Rationale: The correct instruction the nurse should include is to advise the client to avoid drinking grapefruit juice while taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the medication and raising the risk of adverse effects, such as cardiac toxicity. Choices A, C, and D are incorrect. Taking Amiodarone with meals, at bedtime, or increasing intake of sodium-rich foods are not necessary instructions for this medication.

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