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. A healthcare provider is assessing a client who takes Desmopressin for Diabetes Insipidus. For which of the following adverse effects should the healthcare provider monitor?

• A. Hypovolemia
• B. Hypercalcemia
• C. Agitation
• D. Headache

Correct answer: D

Rationale: The correct answer is D: Headache. Headache during desmopressin therapy can indicate water intoxication, which is a potential adverse effect. Desmopressin is a medication used to treat Diabetes Insipidus by reducing excessive urination and thirst. Monitoring for headaches is crucial as it can signal decreased sodium levels due to water retention, leading to water intoxication, which is a serious concern. Hypovolemia, hypercalcemia, and agitation are not typically associated with desmopressin therapy for Diabetes Insipidus.

3. When administering Phenytoin, what should you monitor?

• A. Behavior
• B. Therapeutic blood levels
• C. For signs of Stevens-Johnson syndrome
• D. All of the above

Correct answer: D

Rationale: When administering Phenytoin, monitoring the patient's behavior is important to assess for any changes that may indicate adverse effects. Monitoring therapeutic blood levels helps ensure the medication is within the effective range and not causing toxicity. Additionally, being vigilant for signs of Stevens-Johnson syndrome, a severe skin reaction associated with Phenytoin use, is crucial for early detection and intervention. Therefore, monitoring behavior, therapeutic blood levels, and for signs of Stevens-Johnson syndrome are all essential when administering Phenytoin.

4. A client has a new prescription for Pancrelipase for chronic pancreatitis. Which of the following instructions should be included by the nurse?

• A. Take the medication with meals and snacks.
• B. Chew the tablet thoroughly before swallowing.
• C. Take the medication 1 hour before meals.
• D. Expect the stool to be yellow.

Correct answer: A

Rationale: The correct instruction for taking Pancrelipase is to take it with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This helps optimize the effectiveness of the medication in managing chronic pancreatitis. Choice B is incorrect because Pancrelipase should not be chewed but swallowed whole. Choice C is incorrect as the medication should be taken with meals. Choice D is incorrect because while Pancrelipase can cause stool changes, yellow stool is not an expected outcome.

5. A client is taking Desmopressin for Diabetes Insipidus. For which of the following adverse effects should the nurse monitor?

• A. Hypovolemia
• B. Hypercalcemia
• C. Agitation
• D. Headache

Correct answer: D

Rationale: Headache is an adverse effect that the nurse should monitor for in a client taking Desmopressin for Diabetes Insipidus. It can be an early sign of water intoxication, which is a potential complication of desmopressin therapy due to excessive water retention in the body.

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