Nursing Elites

1. A client is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion?

• A. I signed up for a swimming class.
• B. I've been taking an antacid to help with indigestion.
• C. I've lost 2 pounds since my appointment 2 weeks ago.
• D. The naproxen is easier to take when I crush it and put it in applesauce.

Correct answer: B

Rationale: The client stating that they have been taking an antacid to help with indigestion while on naproxen requires further discussion. This statement suggests potential gastrointestinal distress or interactions between the medications. Antacids can affect the absorption of naproxen or lead to other complications. Therefore, the nurse should address this statement with the client to ensure safe and effective medication management. Choices A, C, and D do not raise immediate concerns related to the client's medication regimen and can be considered positive health behaviors or side effects of treatment that do not require immediate intervention.

2. A client has a new prescription for Lovastatin. Which of the following instructions should be included?

• A. Take this medication on an empty stomach.
• B. Take this medication in the morning.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: Lovastatin should be taken at bedtime because cholesterol production in the liver is highest at night, making the medication more effective in reducing cholesterol levels. By taking it at bedtime, the medication aligns with the body's natural rhythm of cholesterol synthesis, optimizing its therapeutic effects.

3. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital, with a long half-life of 4 days, remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should administer phenobarbital once a day to maintain a consistent therapeutic effect without the need for multiple daily doses. Administering the medication more than once a day would not be necessary and could increase the risk of side effects or toxicity. Therefore, the correct answer is to administer phenobarbital once a day.

4. When starting amitriptyline, a client should be instructed to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Urinary retention
• C. Bradycardia
• D. Dry cough

Correct answer: B

Rationale: When a client starts taking amitriptyline, an important adverse effect to monitor for is urinary retention. Amitriptyline is a tricyclic antidepressant that can cause anticholinergic effects, including urinary retention. It is crucial to educate the client on recognizing and reporting this adverse effect to their healthcare provider. Diarrhea is not a common adverse effect of amitriptyline and is more associated with other medications. Bradycardia is a possible adverse effect of amitriptyline, but urinary retention is a more common and significant concern. Dry cough is not a typical adverse effect of amitriptyline.

5. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client monitor for and report to the provider?

• A. Dry cough
• B. Pedal edema
• C. Bruising
• D. Yellow-tinged vision

Correct answer: D

Rationale: The correct answer is D: Yellow-tinged vision. Yellow-tinged vision is a potential adverse effect of Digoxin and may indicate toxicity. Clients should be instructed to report this symptom promptly to the healthcare provider to prevent complications. Dry cough (choice A) is not typically associated with Digoxin. Pedal edema (choice B) is more commonly seen with heart failure but is not a direct adverse effect of Digoxin. Bruising (choice C) is not a common adverse effect of Digoxin.

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