Nursing Elites

1. A practical nurse (PN) is reviewing teaching with the client and/or significant others about the concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should the PN reinforce?

• A. Benztropine will reduce olanzapine's side effect of urinary retention.
• B. Benztropine potentiates the effect of olanzapine.
• C. Benztropine is used to control the side effects of olanzapine.
• D. The combined effect of these drugs will modify psychotic behavior.

Correct answer: C

Rationale: The correct answer is C because benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with olanzapine use. Choice A is incorrect because benztropine does not directly reduce olanzapine's side effect of urinary retention. Choice B is incorrect as benztropine does not potentiate the effect of olanzapine; its main role is to counteract extrapyramidal symptoms. Choice D is incorrect because the primary purpose of using benztropine alongside olanzapine is to manage side effects, not specifically to modify psychotic behavior.

2. A client diagnosed with angina has been prescribed nitrate isosorbide dinitrate. Which instruction should the practical nurse reinforce in this client's teaching?

• A. Discontinue the medication if dizziness occurs.
• B. Avoid getting up quickly. Always rise slowly.
• C. Take the medication with or without food.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction that the practical nurse should reinforce with a client prescribed nitrate isosorbide dinitrate is to avoid getting up quickly and to rise slowly. Nitrates can cause orthostatic hypotension, a sudden drop in blood pressure when changing positions. By rising slowly, the client can prevent the occurrence of orthostatic hypotension and its associated symptoms. Choices A, C, and D are incorrect because discontinuing the medication without consulting a healthcare provider can be dangerous, taking the medication with or without food does not impact its effectiveness, and increasing potassium intake is not directly related to the use of nitrate isosorbide dinitrate.

3. A client with a history of angina is prescribed amlodipine. The practical nurse (PN) should monitor the client for which adverse effect?

• A. Headache
• B. Peripheral edema
• C. Hyperglycemia
• D. Hypertension

Correct answer: B

Rationale: Amlodipine, a calcium channel blocker, commonly causes peripheral edema as an adverse effect. This is due to its vasodilation effects on blood vessels, leading to fluid accumulation in the extremities. Monitoring for peripheral edema is crucial to assess the client's response to amlodipine and ensure timely intervention if needed.

4. A client with diabetes mellitus type 2 is prescribed dapagliflozin. The nurse should monitor for which potential adverse effect?

• A. Genital infections
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Genital infections. Dapagliflozin, a medication used in diabetes mellitus type 2, is associated with an increased risk of genital infections. Its mechanism of action involves promoting glucose excretion through the urine, creating a favorable environment for microbial growth in the genital area. Monitoring for genital infections is crucial when a client is prescribed dapagliflozin. Hypoglycemia (choice B) is not a common adverse effect of dapagliflozin since it does not directly lower blood glucose levels. Hyperglycemia (choice C) is also unlikely as dapagliflozin is intended to help lower blood glucose levels. Nausea (choice D) is a less common side effect of dapagliflozin compared to genital infections.

5. A client with asthma is receiving long-term glucocorticoid therapy. The nurse includes a risk for impaired skin integrity on the client's problem list. What is the rationale for including this problem?

• A. Abnormal fat deposits impair circulation
• B. Frequent diarrhea can lead to skin issues
• C. Thinned skin bruises easily
• D. Decreased serum glucose prolongs healing time

Correct answer: C

Rationale: The correct answer is C. Glucocorticoids can cause skin thinning, which increases the likelihood of bruising. Thinning of the skin due to glucocorticoid therapy makes it more fragile and prone to injury, such as bruising, even with minimal trauma. Choices A, B, and D are incorrect because abnormal fat deposits impairing circulation, frequent diarrhea causing skin issues, and decreased serum glucose prolonging healing time are not direct effects of glucocorticoid therapy on skin integrity.

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