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 Prednisone. Which of the following laboratory values should the nurse monitor?

• A. Serum potassium
• B. Serum calcium
• C. Serum sodium
• D. Serum glucose

Correct answer: D

Rationale: The correct answer is D, Serum glucose. Prednisone is a corticosteroid that can lead to hyperglycemia. Monitoring serum glucose levels is essential to assess for elevated blood sugar levels. Choices A, B, and C are incorrect as Prednisone does not directly affect potassium, calcium, or sodium levels.

3. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

4. A client with asthma has new prescriptions for cromolyn and albuterol by nebulizer. Which statement by the client indicates an understanding of the teaching?

• A. If my breathing begins to feel tight, I will use the cromolyn immediately.
• B. I will be sure to take the albuterol before taking the cromolyn.
• C. I will use both medications immediately after exercising.
• D. I will administer the medications 10 minutes apart.

Correct answer: B

Rationale: The correct answer is B. Taking albuterol before cromolyn ensures that the airways are open, allowing the cromolyn to reach the lungs effectively. Choice A is incorrect because cromolyn is a preventive medication and should be used regularly, not just when symptoms worsen. Choice C is incorrect because medications should be used as prescribed, not based on a specific event like exercising. Choice D is incorrect because there is no need to wait 10 minutes between administering these two medications when using a nebulizer.

5. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?

• A. Increase your intake of high-fiber foods.
• B. Take the medication with grapefruit juice.
• C. Expect to feel drowsy or lightheaded.
• D. Avoid dairy products while taking this medication.

Correct answer: A

Rationale: The correct instruction to include when a client is prescribed Verapamil is to increase their intake of high-fiber foods. Verapamil can cause constipation as a side effect, and increasing fiber intake can help prevent constipation. High-fiber foods promote bowel regularity and can counteract the constipating effects of Verapamil. Choices B, C, and D are incorrect because taking Verapamil with grapefruit juice can lead to adverse reactions, drowsiness or lightheadedness is not a typical side effect of Verapamil, and there is no need to avoid dairy products specifically while taking this medication.

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