Nursing Elites

1. A healthcare provider is caring for a client who has a new prescription for Clonidine. Which of the following adverse effects should the healthcare provider monitor?

• A. Drowsiness
• B. Dry mouth
• C. Weight gain
• D. Insomnia

Correct answer: B

Rationale: The correct answer is B: Dry mouth. Dry mouth is a common adverse effect of Clonidine. Clonidine can cause a reduction in salivary flow, leading to dry mouth. This symptom can be managed by increasing fluid intake or using sugar-free gum or candy to stimulate saliva production. Choices A, C, and D are incorrect. While drowsiness and insomnia are potential side effects of Clonidine, dry mouth is more commonly reported. Weight gain is not typically associated with Clonidine use.

2. A client has a new prescription for Warfarin. Which of the following herbal supplements should the client be instructed to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by affecting its metabolism. Echinacea, garlic, and ginseng are also known to interact with Warfarin, either by increasing the risk of bleeding or altering its anticoagulant effects. However, St. John's wort is particularly significant due to its potent enzyme-inducing properties that can lead to subtherapeutic levels of Warfarin, potentially increasing the risk of blood clots.

3. When teaching a client with a new prescription for Timolol how to insert eye drops, which instruction should the nurse include?

• A. Press your finger on the inside corner of your eye for 1 minute after application.
• B. Apply the eye drops directly on the cornea.
• C. Drop the prescribed amount of medication into the center of the conjunctival sac.
• D. Wipe your eyes gently with a tissue immediately after application.

Correct answer: C

Rationale: The correct way to administer eye drops is by instructing the client to drop the prescribed amount of medication into the center of the conjunctival sac. This technique helps in proper distribution and absorption of the medication. Choice A is incorrect as pressing the inside corner of the eye is not necessary. Choice B is incorrect because applying eye drops directly on the cornea can cause irritation and discomfort. Choice D is incorrect as wiping the eyes immediately after application can remove the medication and reduce its effectiveness.

4. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.

5. A healthcare provider is caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

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