Nursing Elites

1. A client has a new prescription for nitroglycerin. Which of the following adverse effects should the nurse instruct the client to report that can indicate the medication is effective?

• A. Headache
• B. Nausea
• C. Dizziness
• D. Dry mouth

Correct answer: A

Rationale: Headache is a common side effect of nitroglycerin due to its vasodilatory effects. It can indicate that the medication is working effectively by dilating blood vessels, improving blood flow, and reducing cardiac workload. Therefore, the client should report experiencing headaches as it may suggest the therapeutic action of nitroglycerin. Nausea, dizziness, and dry mouth are not typically associated with the therapeutic effects of nitroglycerin and should be reported as adverse effects that may necessitate medical attention.

2. What instruction should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine for a client with poison ivy?

• A. Administer the medication with food.
• B. Chew on sugarless gum or suck on hard, sour candies.
• C. Place a humidifier at your bedside every evening.
• D. Discontinue the medication and notify your provider.

Correct answer: B

Rationale: The correct instruction for dry mouth associated with diphenhydramine is to chew on sugarless gum or suck on hard, sour candies. These actions stimulate saliva production, providing relief from dry mouth. Administering the medication with food (Choice A) may help reduce stomach upset but won't address dry mouth. Placing a humidifier at the bedside (Choice C) can help with dry air-related issues but won't specifically target dry mouth. Discontinuing the medication (Choice D) without consulting the provider is not recommended and may lead to inadequate treatment of poison ivy.

3. A client with congestive heart failure taking digoxin refused breakfast and is complaining of nausea and weakness. Which action should the nurse take first?

• A. Check the client's vital signs.
• B. Request a consult with a dietitian.
• C. Suggest that the client rests before eating the meal.
• D. Request an order for an antiemetic.

Correct answer: A

Rationale: The nurse should check the client's vital signs first because nausea and weakness can be signs of digoxin toxicity. Vital signs can provide immediate information on the client's condition and help guide further interventions. Monitoring vital signs will allow the nurse to assess for bradycardia, a common sign of digoxin toxicity. Requesting a dietitian consult (choice B) may be necessary but addressing the immediate concern of toxicity is the priority. Suggesting rest before eating (choice C) may not address the underlying issue of digoxin toxicity. Requesting an antiemetic (choice D) can be considered later but is not the initial action needed in this situation.

4. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)

• A. A client at 8 weeks of gestation who asks for an Influenza immunization
• B. A client who takes Prednisone and has a possible Fungal infection
• C. A client who has chronic liver disease and is taking Hydrocodone
• D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide

Correct answer: B

Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.

5. A client has been prescribed Alendronate for osteoporosis. Which of the following instructions should the nurse provide?

• A. Take the medication with a full glass of water after getting up in the morning.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Chew the tablet and mix it with applesauce if swallowing is difficult.
• D. Take the medication at bedtime to minimize the chance of esophageal irritation.

Correct answer: A

Rationale: The correct instruction for a client prescribed Alendronate for osteoporosis is to take the medication with a full glass of water after getting up in the morning. This is important to reduce the risk of esophageal irritation. Choice B is also correct as remaining upright for at least 30 minutes after taking the medication helps prevent esophageal irritation and ensures proper absorption. Choice C is incorrect because Alendronate tablets should not be chewed or mixed with any other substance. Choice D is incorrect as taking the medication at bedtime increases the risk of esophageal irritation due to lying down after ingestion.

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