Nursing Elites

1. A client receives a local anesthetic of Lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client?

• A. Seizures
• B. Tachycardia
• C. Hypertension
• D. Fever

Correct answer: A

Rationale: Seizures are a potential adverse reaction to local anesthetics like Lidocaine. Lidocaine can affect the central nervous system and, in some cases, lead to seizure activity. Therefore, it is important for the nurse to monitor the client for any signs of seizures during and after the administration of Lidocaine.

2. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

3. A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Dry mouth
• C. Insomnia
• D. Hypertension

Correct answer: B

Rationale: Dry mouth is a common adverse effect associated with clonidine use. Clonidine is known to cause xerostomia (dry mouth) due to its effect on reducing salivary flow. Monitoring for dry mouth is important as it can lead to oral health issues and discomfort for the client. Diarrhea, insomnia, and hypertension are not typically associated with clonidine use, making them less likely adverse effects to monitor for in this scenario.

4. A client with early Parkinson's disease has been prescribed pramipexole. What adverse effect should the nurse instruct the client to monitor for?

• A. Hallucinations
• B. Increased salivation
• C. Diarrhea
• D. Discoloration of urine

Correct answer: A

Rationale: The correct answer is A: Hallucinations. Pramipexole can lead to hallucinations within 9 months of the initial dose, which may necessitate discontinuation of the medication. Monitoring for hallucinations is crucial to ensure early detection and management to prevent any adverse outcomes. Choice B, increased salivation, is not a common adverse effect of pramipexole. Choice C, diarrhea, is not typically associated with pramipexole use. Choice D, discoloration of urine, is not a known adverse effect of pramipexole and is not typically a concern with this medication.

5. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?

• A. Vitamin K
• B. Calcium carbonate
• C. Acetaminophen
• D. Ranitidine

Correct answer: C

Rationale: The correct answer is Acetaminophen. Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking warfarin. Warfarin works by inhibiting the clotting factors dependent on vitamin K, so Vitamin K intake should be consistent but not excessive. Calcium carbonate and ranitidine do not significantly increase the risk of bleeding when used concurrently with Warfarin.

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