Nursing Elites

1. A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?

• A. Irregular heart rhythm
• B. Abnormal uterine bleeding
• C. Yellowing of the sclera or dark-colored urine
• D. Difficulty swallowing

Correct answer: B

Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.

2. Medications classified as angiotensin II receptor agents typically end in?

• A. Sartan
• B. Ase
• C. Olol
• D. Pril

Correct answer: A

Rationale: Angiotensin II receptor agents belong to the drug class called angiotensin II receptor blockers (ARBs). The generic names of ARBs usually end in -sartan, helping to identify this specific class of medications. Therefore, medications that end in -sartan are likely to be angiotensin II receptor agents. Choices B, C, and D are incorrect because drugs ending in -ase (like streptokinase), -olol (like propranolol), and -pril (like lisinopril) typically belong to different drug classes with distinct mechanisms of action.

3. A healthcare professional is preparing to administer IV Dantrolene to a client who has developed Malignant Hyperthermia during surgery. Which of the following actions should the healthcare professional take?

• A. Dilute the medication with sterile water and administer it rapidly.
• B. Store the medication in a refrigerator until use.
• C. Administer the medication through a large-bore IV catheter.
• D. Administer the medication via an infusion pump over 60 minutes.

Correct answer: C

Rationale: Dantrolene should be administered through a large-bore IV catheter because it is highly irritating to tissues and can cause vein irritation or thrombophlebitis if administered through a small vein. Using a large-bore IV catheter helps to minimize the risk of tissue damage and ensures proper and safe administration of the medication in emergency situations like Malignant Hyperthermia. Choices A, B, and D are incorrect because diluting the medication with sterile water and administering it rapidly can lead to tissue damage, storing the medication in a refrigerator is not necessary, and administering the medication via an infusion pump over 60 minutes is not appropriate in emergency situations like Malignant Hyperthermia where rapid administration is crucial.

4. What is an expected outcome for Lithium use in patients with bipolar disorder?

• A. Reduced risk of myocardial infarction
• B. Reduced risk of GI ulcers
• C. Decrease in respiratory distress
• D. Decreased incidence of acute manic episodes

Correct answer: D

Rationale: The correct answer is D: Decreased incidence of acute manic episodes. Lithium is commonly used to treat bipolar disorder by helping to stabilize mood and reduce the intensity and frequency of manic episodes. This leads to better overall management of the disorder. Choices A, B, and C are incorrect because lithium is not known to reduce the risk of myocardial infarction, GI ulcers, or respiratory distress in patients with bipolar disorder.

5. A client has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. After more than 5 days of use, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion. This occurs due to prolonged vasoconstriction of nasal blood vessels, causing worsening nasal congestion. Sedation (choice A) is not a common adverse effect of phenylephrine nasal drops. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with this medication.

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