Nursing Elites

1. A client has a prescription for long-term use of oral prednisone for the treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: The correct answer is weight gain. Oral prednisone can lead to weight gain and fluid retention due to its sodium and water retention effects. Monitoring weight changes is crucial to identify and manage this adverse effect. Choices B, C, and D are incorrect because oral prednisone is not typically associated with nervousness, bradycardia, or constipation as common adverse effects. Therefore, the nurse should primarily focus on monitoring weight gain in clients prescribed long-term oral prednisone therapy.

2. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify the trough levels of a medication accurately, the nurse should obtain a blood specimen immediately before administering the next dose of the medication. The trough level represents the lowest concentration of the medication in the bloodstream, typically right before the next dose is due. This timing ensures an accurate assessment of the drug's concentration in the body at its lowest point, aiding in determining the drug's effectiveness and potential toxicity levels. Choice B is incorrect because waiting for 24 hours would not provide the trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect as obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level.

3. During discharge instructions, a client with a new prescription for Phenytoin should be advised to take which of the following actions?

• A. Brush and floss your teeth regularly.
• B. Avoid drinking grapefruit juice.
• C. Take this medication on an empty stomach.
• D. Increase your intake of calcium-rich foods.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for Phenytoin is to brush and floss their teeth regularly. Phenytoin is known to cause gingival hyperplasia, a condition that affects the gums. By maintaining good oral hygiene practices such as regular brushing and flossing, the client can help minimize the risk of developing this side effect. Choices B, C, and D are incorrect. Avoiding grapefruit juice is more relevant for medications affected by grapefruit juice metabolism, taking medication on an empty stomach is not specifically indicated for Phenytoin, and increasing calcium-rich foods is not directly related to the side effects or administration of Phenytoin.

4. A client asks the nurse to explain the difference between stable and unstable angina. What is the best response by the nurse?

• A. "Stable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• B. "Unstable angina is caused by spasms of the coronary arteries. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• C. "Unstable angina is predictable in its frequency, intensity, and duration. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• D. "Stable angina is caused by spasms of the coronary arteries. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?

Correct answer: A

Rationale: Stable angina is typically triggered by physical exertion or emotional stress and is predictable in its frequency, intensity, and duration. In contrast, unstable angina is characterized by angina episodes that are unexpected, more severe, prolonged, and can occur at rest. Understanding these differences can help healthcare providers assess and manage angina episodes effectively, ensuring appropriate interventions are implemented promptly based on the type of angina present.

5. What symptom would alert the healthcare professional to hold Albuterol and notify a healthcare professional immediately?

• A. Insomnia
• B. Paradoxical bronchospasm
• C. Nausea
• D. Headache

Correct answer: B

Rationale: If a patient experiences paradoxical bronchospasm after taking Albuterol, the medication should be withheld, and a healthcare professional should be notified immediately. Paradoxical bronchospasm is a serious adverse reaction where the airways constrict instead of dilating, leading to breathing difficulties. This condition requires prompt medical attention to assess and manage the patient's respiratory status. The other options, insomnia, nausea, and headache, are not typically associated with the need to hold Albuterol and notify a healthcare professional immediately.

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