Nursing Elites

1. A client has a new prescription for Atenolol. Which of the following client statements indicates an understanding of the teaching?

• A. I should monitor my blood pressure regularly.
• B. I will take this medication at bedtime.
• C. I will take this medication with a high-fat meal.
• D. I should increase my intake of potassium-rich foods.

Correct answer: A

Rationale: The correct answer is A. Clients taking Atenolol, a beta-blocker, should monitor their blood pressure regularly to ensure the medication is effectively managing their condition. Monitoring blood pressure helps in assessing the drug's effectiveness and identifying any potential side effects that may influence blood pressure levels. Choices B, C, and D are incorrect because taking Atenolol at bedtime, with a high-fat meal, or increasing potassium-rich foods intake are not recommended actions associated with this medication and do not demonstrate an understanding of the teaching.

2. A client has a new prescription for a combination of oral NRTIs (abacavir, lamivudine, and zidovudine) for the treatment of HIV. Which of the following statements should the nurse include in teaching the client?

• A. These medications work by blocking HIV entry into cells.
• B. These medications work by weakening the cell wall of the HIV virus.
• C. These medications work by inhibiting enzymes to prevent HIV replication.
• D. These medications work by preventing protein synthesis within the HIV cell.

Correct answer: C

Rationale: The NRTI antiretroviral medications this client is prescribed work by inhibiting the enzyme reverse transcriptase, thus preventing HIV replication. By inhibiting this crucial enzyme, the drug interferes with the virus's ability to replicate and spread in the body. Choice A is incorrect because NRTIs do not block HIV entry into cells. Choice B is incorrect as NRTIs do not weaken the cell wall of the virus. Choice D is incorrect as NRTIs do not prevent protein synthesis within the HIV cell.

3. A client has a new prescription for Nifedipine. Which of the following adverse effects should the nurse monitor?

• A. Hypertension
• B. Edema
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: Nifedipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should monitor the client for swelling in the lower extremities, as it indicates the onset of edema. Hypertension is typically treated with Nifedipine and is not an adverse effect of the medication. Hyperglycemia and bradycardia are not commonly associated with Nifedipine use. Therefore, the correct adverse effect to monitor for when a client is prescribed Nifedipine is edema.

4. A client has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?

• A. Orthostatic hypotension
• B. Hearing loss
• C. Gastrointestinal bleeding
• D. Weight loss

Correct answer: A

Rationale: Orthostatic hypotension is a known adverse effect of MAOIs, such as Phenelzine. It is characterized by a drop in blood pressure upon standing, which can lead to dizziness or fainting. Monitoring for orthostatic hypotension is crucial when administering MAOIs to prevent potential complications. Hearing loss (Choice B) is not a typical adverse effect associated with Phenelzine. Gastrointestinal bleeding (Choice C) is more commonly linked to NSAIDs or anticoagulants. Weight loss (Choice D) is not a typical adverse effect of Phenelzine and is more likely related to other factors such as appetite changes or metabolic issues.

5. A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?

• A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
• B. Leucovorin increases platelet production and prevents bleeding.
• C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
• D. Leucovorin protects healthy cells from Methotrexate's toxic effects.

Correct answer: D

Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment. Choices A, B, and C are incorrect because Leucovorin does not reduce the risk of a transfusion reaction from Methotrexate, increase platelet production, prevent bleeding, or potentiate the cytotoxic effects of Methotrexate. Instead, Leucovorin works by rescuing healthy cells from the toxic effects of Methotrexate.

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