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 Folic Acid. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication with food.
• B. I need to monitor for skin rash while taking this medication.
• C. I need to increase my intake of green, leafy vegetables.
• D. I will stop taking this medication if I feel nauseous.

Correct answer: C

Rationale: The correct answer is C. Folic acid is naturally found in green, leafy vegetables such as spinach and broccoli. Increasing the intake of these vegetables can supplement the prescribed folic acid and help maintain adequate levels in the body. It is essential to understand that dietary sources of folic acid can complement the medication and support overall health. Choices A, B, and D are incorrect because taking folic acid with food, monitoring for skin rash, or stopping the medication if feeling nauseous do not directly relate to enhancing the therapeutic effects of folic acid through dietary intake.

3. A client is prescribed Atorvastatin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin
• D. Sodium

Correct answer: B

Rationale: Creatine kinase should be monitored in clients taking Atorvastatin as it can indicate muscle damage, a serious adverse effect of statins. Elevated creatine kinase levels may suggest myopathy or rhabdomyolysis, which are potential complications of statin therapy.

4. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Take off the nitroglycerin patch if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction is to remove the nitroglycerin patch each evening to prevent tolerance. This allows for a 10- to 12-hour nitrate-free period daily, reducing the risk of developing tolerance to nitroglycerin. Cutting the patch in half is not recommended because it can alter the dosing and absorption rate, leading to inadequate symptom control. Taking off the patch for a headache is not necessary as headaches are a common side effect that may improve with continued use. Applying a new patch every 48 hours is not correct as it may not provide continuous symptom relief for angina.

5. A healthcare provider in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings are indicative of this condition?

• A. Insidious onset of painless loss of vision
• B. Gradual reduction in peripheral vision
• C. Severe pain around the eyes
• D. Intraocular pressure of 12mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a characteristic symptom of acute angle-closure glaucoma. This intense pain is typically accompanied by other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. The acute rise in intraocular pressure leads to these symptoms, indicating a medical emergency that requires immediate attention to prevent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more suggestive of conditions like age-related macular degeneration or diabetic retinopathy. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12mm Hg is within the normal range and not indicative of the acute rise seen in angle-closure glaucoma.

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