Nursing Elites

1. What should be obtained prior to starting olanzapine for a male client with bipolar disorder?

• A. Complete blood count
• B. Family history of hypertension
• C. History of erectile dysfunction
• D. Baseline weight

Correct answer: D

Rationale: Baseline weight should be obtained prior to starting olanzapine in a male client with bipolar disorder to monitor for potential weight gain associated with the medication. Olanzapine is known to cause weight gain and monitoring the baseline weight can help in assessing any changes during treatment.

2. A client with a diagnosis of generalized anxiety disorder is prescribed paroxetine. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Paroxetine, used for generalized anxiety disorder, can cause drowsiness. Clients should be advised not to drive or operate heavy machinery until they know how the medication affects them. Dry mouth, nausea, and headache are potential side effects of other medications but are not commonly associated with paroxetine. Drowsiness is a common side effect for paroxetine and can impact a client's ability to perform tasks that require alertness.

3. A client with a history of stroke is prescribed clopidogrel. The nurse should monitor the client for which potential side effect?

• A. Bleeding
• B. Bruising
• C. Nausea
• D. Headache

Correct answer: A

Rationale: Clopidogrel is an antiplatelet medication that works to prevent blood clots, but it can also increase the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, or unusual bleeding from the gums. Prompt identification and management of bleeding are crucial to prevent complications. Choices B, C, and D are incorrect because while bruising and other symptoms can occur as a result of bleeding, they are not the primary side effect to monitor for with clopidogrel. Nausea and headache are less commonly associated with clopidogrel use compared to bleeding.

4. When a client with hypertension is prescribed losartan, what potential side effect should the nurse monitor for?

• A. Hyperkalemia
• B. Dry cough
• C. Bradycardia
• D. Headache

Correct answer: B

Rationale: The correct answer is B: Dry cough. Losartan, an angiotensin II receptor blocker, can lead to a dry cough as a potential side effect. This occurs due to the drug's effect on the bradykinin pathway in the lungs. Monitoring for a dry cough is essential as it may indicate the need for further evaluation or medication adjustment to manage this adverse reaction.

5. A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer the requested medication, the client is seen talking and laughing with visiting family. What action should the PN take?

• A. Hold the pain medication until after the visitors leave.
• B. Notify the healthcare provider of the client's drug-seeking behavior.
• C. Administer analgesia as requested by the client.
• D. Inform the client that the medication is not needed based on their behavior.

Correct answer: C

Rationale: The correct action for the PN in this situation is to administer the analgesia as requested by the client. Pain management is based on the client's self-report of pain, which is the most reliable indicator of pain intensity. Analgesics should be given promptly when pain occurs and before it worsens. Following the administration of medication, the PN should discuss the situation with the charge nurse for further guidance or assessment.

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