Nursing Elites

1. While providing teaching to a client with a new prescription for Enalapril, the nurse should instruct the client to report which of the following manifestations as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: The correct answer is 'B: Dry cough.' Enalapril is an ACE inhibitor known to cause a persistent dry cough as a common adverse effect. This cough should be reported to the healthcare provider for further evaluation, as it may indicate a potential issue with the medication that needs attention to ensure the client's well-being. Tremors (Choice A), drowsiness (Choice C), and hyperactivity (Choice D) are not typically associated with Enalapril use. Therefore, they are incorrect choices for this question.

2. When administering IV Acyclovir to a client with Varicella, what action should the nurse take?

• A. Administer a stool softener
• B. Decrease fluid intake following infusion
• C. Infuse Acyclovir over 1 hr
• D. Monitor for hypotension

Correct answer: C

Rationale: When administering IV Acyclovir to a client with Varicella, the nurse should infuse the medication over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects such as renal damage. Therefore, it is crucial to follow the recommended infusion rate to ensure the client's safety and well-being. Choice A is incorrect as stool softeners are not indicated in this situation. Choice B is incorrect because fluid intake should be maintained or increased to prevent dehydration and support kidney function. Choice D is incorrect as monitoring for hypotension is not specifically related to the administration of IV Acyclovir in Varicella.

3. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. It is essential to alternate nostrils daily when inhaling the medication to ensure equal distribution and optimal absorption. This technique helps prevent irritation and congestion in one nostril and enhances the effectiveness of the medication. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed, applied topically, or taken as a liquid medication after meals. Therefore, instructing the client to alternate nostrils during inhalation is the most appropriate teaching for this medication.

4. A healthcare provider is providing instructions to the parent of an adolescent client who has a new prescription for Albuterol, PO. Which of the following instructions should the healthcare provider include?

• A. You should not use this medication for an acute asthma attack.'
• B. Tremors may be an adverse effect of this medication.'
• C. Long-term use of this medication can lead to hyperglycemia.'
• D. This medication can inhibit skeletal growth.'

Correct answer: B

Rationale: Tremors may occur as a result of excessive stimulation of beta2 receptors in skeletal muscles when using Albuterol. It is important to educate the parent about potential adverse effects to ensure proper monitoring and management of the adolescent client's medication regimen.

5. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

• A. 2+ deep tendon reflexes
• B. 2+ pedal edema
• C. 24 mL/hr urinary output
• D. Respirations 12/min

Correct answer: C

Rationale: In a client receiving Magnesium Sulfate IV continuous infusion for Preeclampsia, a urinary output less than 25 to 30 mL/hr is indicative of magnesium sulfate toxicity and should be promptly reported to the provider for further evaluation and management. Therefore, the correct answer is C. Option A, 2+ deep tendon reflexes, are expected findings in a client receiving magnesium sulfate and do not require immediate reporting. Option B, 2+ pedal edema, is a common symptom of preeclampsia and typically does not require immediate intervention. Option D, respirations 12/min, are within the normal range and do not indicate an immediate need for reporting to the provider.

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