Nursing Elites

1. A client has a new prescription for atenolol. Which of the following findings should the nurse instruct the client to monitor for as an adverse effect of this medication?

• A. Tachycardia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypertension

Correct answer: C

Rationale: Atenolol is a beta-blocker that works by slowing down the heart rate. An adverse effect of atenolol is bradycardia, characterized by a slower than normal heart rate. The nurse should instruct the client to monitor for signs of bradycardia, such as a slow heart rate, while taking atenolol. Therefore, the correct answer is to monitor for bradycardia. Tachycardia (Choice A) is not an expected adverse effect of atenolol as it actually reduces heart rate. Hypoglycemia (Choice B) is not a typical adverse effect of atenolol. Hypertension (Choice D) is not an adverse effect of atenolol, as atenolol is commonly used to manage hypertension.

2. 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.

3. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer subcutaneously in a large muscle mass to prevent injury.
• B. Ensure that the medication is kept at room temperature until just prior to administration.
• C. Invert vial gently to mix well before withdrawing dose.
• D. Discard vial after removing one dose of the medication.

Correct answer: D

Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.

4. A client has a new prescription for spironolactone. The client should be monitored for which of the following adverse effects?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypokalemia
• D. Hypercalcemia

Correct answer: A

Rationale: Corrected Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia as an adverse effect. Hyperkalemia is characterized by elevated levels of potassium in the blood, which can be dangerous and lead to cardiac arrhythmias. Therefore, monitoring for signs and symptoms of hyperkalemia is crucial when a client is taking spironolactone. Choices B, C, and D are incorrect because spironolactone is not known to cause hyponatremia, hypokalemia, or hypercalcemia as adverse effects.

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

• A. I will take this medication at bedtime.
• B. I should avoid eating grapefruit while taking this medication.
• C. I will need to monitor my blood sugar closely while taking this medication.
• D. I will stop taking the medication if I develop muscle pain.

Correct answer: B

Rationale: The correct answer is B. Grapefruit can increase the levels of simvastatin in the blood, leading to an increased risk of serious side effects, including muscle pain or damage. Therefore, it is crucial for the client to avoid consuming grapefruit while taking this medication to prevent potential complications.

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