Nursing Elites

1. When educating a client with early Parkinson's disease about pramipexole, what adverse effect should the nurse advise 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, especially within 9 months of starting the medication, and may necessitate discontinuation. Hallucinations are a serious adverse effect that the client should be aware of and report promptly to their healthcare provider for evaluation and management. Increased salivation (choice B), diarrhea (choice C), and discoloration of urine (choice D) are not common adverse effects associated with pramipexole and are not typically emphasized in client education for this medication.

2. 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.

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

• A. Take this medication at bedtime.
• B. Increase your fluid intake.
• C. Avoid foods high in calcium.
• D. Take this medication with meals.

Correct answer: B

Rationale: Allopurinol can cause kidney stones due to the formation of uric acid crystals, so it is crucial for the client to increase their fluid intake. Adequate hydration helps to prevent the formation of kidney stones by diluting the urine and promoting the excretion of uric acid. Therefore, advising the client to increase their fluid intake is essential in preventing this adverse effect while taking Allopurinol.

4. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.

5. A client is starting a new prescription for verapamil. Which of the following instructions should be included?

• A. Take the medication with a full glass of water.
• B. Avoid grapefruit juice.
• C. Monitor blood pressure regularly.
• D. Monitor heart rate daily.

Correct answer: B

Rationale: Clients prescribed verapamil should be advised to avoid grapefruit juice as it can potentiate the drug's effects, leading to adverse reactions. Grapefruit juice can inhibit the metabolism of verapamil, resulting in higher blood levels of the medication and an increased risk of side effects. Instructions such as taking the medication with a full glass of water (Choice A) are not specific to verapamil and are generally recommended. While monitoring blood pressure regularly (Choice C) is important for clients on antihypertensive medications, it is not a direct concern related to verapamil. Monitoring heart rate daily (Choice D) is not a primary consideration when starting verapamil, as it is more commonly used for its effects on blood pressure and arrhythmias rather than heart rate.

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