Nursing Elites

1. A client has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?

• A. Orthostatic hypotension
• B. Hearing loss
• C. Gastrointestinal bleeding
• D. Weight loss

Correct answer: A

Rationale: Orthostatic hypotension is a known adverse effect of MAOIs, such as Phenelzine. It is characterized by a drop in blood pressure upon standing, which can lead to dizziness or fainting. Monitoring for orthostatic hypotension is crucial when administering MAOIs to prevent potential complications. Hearing loss (Choice B) is not a typical adverse effect associated with Phenelzine. Gastrointestinal bleeding (Choice C) is more commonly linked to NSAIDs or anticoagulants. Weight loss (Choice D) is not a typical adverse effect of Phenelzine and is more likely related to other factors such as appetite changes or metabolic issues.

2. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The healthcare provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

• A. Bursitis
• B. Sinusitis
• C. Depression
• D. Glaucoma

Correct answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Choosing option D, Glaucoma, as the correct answer is crucial for the client's safety and to prevent exacerbation of their eye condition. Options A, B, and C are not contraindications for Oxybutynin use and are unrelated to the pharmacological effects of this medication.

3. When administering IV Amphotericin B to a client with a systemic fungal infection, the nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypoglycemia
• B. Constipation
• C. Fever
• D. Hyperkalemia

Correct answer: C

Rationale: The correct answer is fever. Amphotericin B is known to cause adverse effects such as fever, chills, and nausea during infusion. Monitoring for fever is essential as it can indicate an adverse reaction. To manage these effects, pretreatment with diphenhydramine and acetaminophen can be administered.

4. When providing teaching to a client starting therapy with trastuzumab, which finding should the nurse instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a serious adverse effect of trastuzumab. Monitoring and early reporting of respiratory symptoms like dyspnea are essential to prevent further complications and ensure timely intervention. Choices B, C, and D are incorrect because constipation, tinnitus, and dry mouth are not typically associated with trastuzumab therapy and are not priority symptoms that require immediate reporting for this specific medication.

5. A client is receiving Gentamicin. Which of the following laboratory values should the nurse monitor to assess for nephrotoxicity?

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

Correct answer: B

Rationale: When a client is receiving Gentamicin, the nurse should monitor serum creatinine levels to assess for nephrotoxicity. Gentamicin is known to potentially cause nephrotoxicity, leading to impaired kidney function. Monitoring serum creatinine levels helps in early detection of any kidney damage or dysfunction. Serum sodium, serum potassium, and serum glucose levels are not directly related to nephrotoxicity caused by Gentamicin, so they are not the appropriate values to monitor in this case.

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