Nursing Elites

1. A client with Angina Pectoris asks the nurse about the next step if one tablet does not relieve Anginal pain after waiting 5 minutes. Which of the following responses should the nurse make?

• A. Take two more sublingual tablets simultaneously.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes before taking a second sublingual tablet.

Correct answer: B

Rationale: In a situation where Anginal pain persists after taking one sublingual tablet and waiting 5 minutes, it is crucial to call emergency services (911) immediately. This could indicate a myocardial infarction (heart attack) rather than a typical Anginal attack. The client should not take two more sublingual tablets simultaneously without seeking immediate medical help as this could delay appropriate intervention if the pain is due to a heart attack. Taking a sustained-release nitroglycerin capsule is not recommended for immediate relief of acute Anginal pain as it works too slowly. Waiting another 5 minutes before taking a second sublingual tablet is not appropriate if the pain persists, as prompt action is essential in suspected heart-related issues.

2. What finding should a nurse monitor for as an adverse effect when a client has a new prescription for Spironolactone?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an increase in potassium levels. Hyperkalemia can be dangerous, causing muscle weakness and cardiac dysrhythmias. Monitoring potassium levels closely is crucial when a client is on Spironolactone. Hypoglycemia (choice B) is incorrect because Spironolactone does not typically affect blood glucose levels. Hypocalcemia (choice C) and hyponatremia (choice D) are also incorrect as Spironolactone's primary impact is on potassium levels.

3. A healthcare professional is preparing to administer verapamil by IV bolus to a client who is experiencing cardiac dysrhythmias. For which of the following adverse effects should the healthcare professional monitor when giving this medication?

• A. Hyperthermia
• B. Hypotension
• C. Ototoxicity
• D. Muscle pain

Correct answer: B

Rationale: Verapamil is known to cause hypotension as one of its adverse effects due to its vasodilatory properties. Therefore, it is essential for the healthcare professional to monitor the client's blood pressure closely during and after administration to prevent complications such as severe hypotension. Hyperthermia, ototoxicity, and muscle pain are not commonly associated with verapamil administration, making choices A, C, and D incorrect.

4. A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Dry mouth
• C. Insomnia
• D. Hypertension

Correct answer: B

Rationale: Dry mouth is a common adverse effect associated with clonidine use. Clonidine is known to cause xerostomia (dry mouth) due to its effect on reducing salivary flow. Monitoring for dry mouth is important as it can lead to oral health issues and discomfort for the client. Diarrhea, insomnia, and hypertension are not typically associated with clonidine use, making them less likely adverse effects to monitor for in this scenario.

5. When discussing immunizations, which vaccine series is typically completed before a child's first birthday?

• A. Pneumococcal conjugate vaccine
• B. Meningococcal conjugate vaccine
• C. Varicella vaccine
• D. Rotavirus vaccine

Correct answer: D

Rationale: The correct answer is D, Rotavirus vaccine. The rotavirus vaccine series is usually completed before a child's first birthday. It is given to infants in a series of doses starting at 2 months of age and must be completed by 8 months of age. This vaccine helps protect against severe diarrhea and vomiting caused by rotavirus infection, which is common in infants and young children. Choices A, B, and C are incorrect because the Pneumococcal conjugate vaccine, Meningococcal conjugate vaccine, and Varicella vaccine are not typically completed before a child's first birthday.

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