Nursing Elites

1. Which of the following is not a side effect of the ACE Inhibitor (Captopril)?

• A. Rash
• B. Angioedema
• C. Cough
• D. Congestion

Correct answer: D

Rationale: Congestion is not a common side effect associated with ACE inhibitors such as Captopril. ACE inhibitors are known to cause a dry, persistent cough due to bradykinin accumulation, rash, and angioedema, but congestion is not typically listed as a side effect.

2. A client with osteoporosis has a new prescription for alendronate. Which of the following instructions should the nurse provide?

• A. Take the medication with a meal.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Take the medication with a glass of juice.
• D. Take the medication with milk or food.

Correct answer: B

Rationale: The correct instruction for a client taking alendronate is to remain upright for at least 30 minutes after administration. This is essential to prevent esophageal irritation and ensure the medication reaches the stomach properly. Remaining upright reduces the risk of side effects such as esophagitis. Choices A, C, and D are incorrect as alendronate should not be taken with a meal, juice, milk, or food to optimize its absorption and effectiveness.

3. A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)

• A. Expect therapeutic effects in 1-3 weeks.
• B. Discontinue the medication gradually under healthcare provider supervision.
• C. Change positions slowly to minimize dizziness.
• D. Increase dietary fiber intake to prevent constipation.

Correct answer: C

Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. The therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so increasing dietary fiber intake would be recommended to prevent constipation, making choice D incorrect.

4. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?

• A. Inspect the skin for redness and irritation around the injection site.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to lie down for 30 minutes after oral administration.
• D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.

Correct answer: B

Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.

5. A healthcare provider is providing discharge instructions to a client who is prescribed Warfarin. Which of the following dietary instructions should the provider include?

• A. Increase your intake of leafy green vegetables.
• B. Avoid foods high in vitamin K.
• C. Increase your intake of dairy products.
• D. Avoid foods high in iron.

Correct answer: B

Rationale: The correct answer is to avoid foods high in vitamin K. Vitamin K can interfere with the effectiveness of Warfarin by counteracting its anticoagulant effects. Foods high in vitamin K, such as leafy green vegetables, should be limited in the diet of individuals taking Warfarin to maintain a consistent level of the medication's effectiveness. Choices A, C, and D are incorrect as increasing intake of leafy green vegetables (choice A) and dairy products (choice C) may increase the intake of vitamin K, which is not recommended, and avoiding foods high in iron (choice D) is not directly related to Warfarin therapy.

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