Nursing Elites

1. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: The correct answer is 'Orthostatic hypotension.' When administering Amitriptyline, the nurse should monitor for orthostatic hypotension. This condition can occur due to the drug's anticholinergic effects, leading to a sudden drop in blood pressure when standing up. Symptoms may include dizziness, lightheadedness, and an increased risk of falls. Monitoring for signs of orthostatic hypotension is crucial to prevent complications. Choices A, B, and C are incorrect as decreased appetite, explosive diarrhea, and decreased pulse rate are not typically associated with the administration of Amitriptyline.

2. A client has a new prescription for colchicine to treat gout. Which of the following instructions should be included?

• A. Take this medication with food if nausea develops.
• B. Monitor for muscle pain.
• C. Expect to have increased bruising.
• D. Increase your intake of grapefruit juice.

Correct answer: B

Rationale: Monitoring for muscle pain is crucial when taking colchicine because it can lead to rhabdomyolysis, a serious condition characterized by muscle breakdown. This adverse effect needs prompt identification to prevent complications. Choices A, C, and D are incorrect because taking colchicine with food, experiencing increased bruising, or increasing grapefruit juice intake are not relevant instructions for a client prescribed colchicine for gout.

3. A client with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.

4. When caring for a school-age child with a new prescription for Atomoxetine, the nurse should monitor the client for which of the following adverse effects of this medication?

• A. Kidney toxicity
• B. Liver damage
• C. Seizure activity
• D. Adrenal insufficiency

Correct answer: B

Rationale: The correct answer is B: Liver damage. Atomoxetine can lead to liver damage as an adverse effect. Symptoms of liver damage include jaundice, upper abdominal tenderness, dark urine, and elevated liver enzymes. Monitoring for these signs is crucial when a child is on this medication. Choices A, C, and D are incorrect because Atomoxetine is not known to cause kidney toxicity, seizure activity, or adrenal insufficiency as primary adverse effects.

5. A patient is prescribed acetaminophen 650 mg PO every 6 hr PRN for pain. The available acetaminophen liquid is 500 mg/5 mL. How many mL should the nurse administer per dose?

• A. 6.5 mL
• B. 7 mL
• C. 5 mL
• D. 8 mL

Correct answer: A

Rationale: To calculate the volume to administer: (Desired dose / Concentration) = Volume to administer. In this case, (650 mg / 500 mg) x 5 mL = 6.5 mL. Therefore, the nurse should administer 6.5 mL of acetaminophen liquid per dose to provide the prescribed 650 mg of acetaminophen. Choice B, 7 mL, is incorrect because the correct calculation results in 6.5 mL. Choice C, 5 mL, is incorrect as it is the concentration of the acetaminophen liquid, not the final volume needed. Choice D, 8 mL, is incorrect because it does not reflect the accurate calculation based on the prescription and concentration.

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