Nursing Elites

1. A client with Subacute Bacterial Endocarditis is receiving Streptomycin IM among other antibiotics. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?

• A. Extremity paresthesias
• B. Urinary retention
• C. Severe constipation
• D. Complex partial seizures

Correct answer: A

Rationale: The correct answer is extremity paresthesias. Streptomycin, used to treat infections like Subacute Bacterial Endocarditis, can cause paresthesias in the hands and feet as an adverse effect. Monitoring for this symptom is vital to detect and manage it promptly. Choices B, C, and D are incorrect because urinary retention, severe constipation, and complex partial seizures are not commonly associated adverse effects of Streptomycin.

2. A client is prescribed Diltiazem. Which of the following findings should the nurse monitor?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperkalemia

Correct answer: B

Rationale: Diltiazem is a calcium channel blocker that can cause bradycardia as an adverse effect due to its negative chronotropic properties, slowing down the heart rate. Therefore, the nurse should monitor the client for signs of bradycardia by regularly assessing the heart rate to prevent potential complications. Monitoring for tachycardia (choice A) is incorrect as diltiazem typically does not cause tachycardia. Hypertension (choice C) is not a typical finding to monitor for with diltiazem use. Hyperkalemia (choice D) is not directly associated with diltiazem administration.

3. A healthcare professional is preparing to administer IV Furosemide to a client with heart failure. Which of the following actions should the healthcare professional take?

• A. Administer the medication undiluted.
• B. Dilute the medication with normal saline.
• C. Administer the medication through a central line.
• D. Administer the medication slowly over 2 minutes.

Correct answer: D

Rationale: Furosemide, when administered intravenously, should be given slowly over 2 minutes to reduce the risk of ototoxicity, a known adverse effect of rapid infusion. This method allows for better monitoring of the client's response and decreases the likelihood of adverse reactions associated with a faster administration rate.

4. A client is taking oral Oxycodone and Ibuprofen in recommended doses. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: When Oxycodone, a narcotic analgesic, and Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), are taken together, they work synergistically to enhance the pain-relieving effects of both medications. These drugs act through different mechanisms, leading to a combined analgesic effect that is more effective than when used alone. Therefore, the interaction between Oxycodone and Ibuprofen results in an increase in the expected therapeutic effect of both medications.

5. A healthcare professional is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare professional should monitor the client for which of the following as an adverse effect of this medication?

• A. Bradycardia
• B. Hyperkalemia
• C. Hypoglycemia
• D. Hypocalcemia

Correct answer: B

Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, which leads to potassium retention. Monitoring potassium levels is essential to prevent potential complications associated with hyperkalemia. The other options, bradycardia, hypoglycemia, and hypocalcemia, are not typically associated with Enalapril use and are less likely to occur as adverse effects.

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