Nursing Elites

1. When assessing a client taking Gemfibrozil, which of the following findings should the nurse identify as an adverse reaction to the medication?

• A. Mental status changes
• B. Tremor
• C. Jaundice
• D. Pneumonia

Correct answer: C

Rationale: Jaundice is an adverse reaction that can occur in clients taking Gemfibrozil due to the potential development of liver impairment. Other symptoms of liver impairment may include anorexia and upper abdominal discomfort. Monitoring for signs of jaundice is crucial to detect and manage adverse effects of the medication promptly. Mental status changes (choice A) are not commonly associated with Gemfibrozil use. Tremor (choice B) is not a typical adverse reaction of Gemfibrozil. Pneumonia (choice D) is not directly linked to Gemfibrozil use but can be a complication in some cases.

2. 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.

3. A healthcare professional is educating a client who is starting therapy with topotecan. Which of the following findings should the professional instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The correct answer is C: 'Sore throat.' Clients starting therapy with topotecan should be instructed to report a sore throat because it can indicate an infection due to the immunosuppressive effects of the medication. Infections can be serious in clients undergoing chemotherapy, so early detection and treatment are crucial to prevent complications. Choices A, B, and D are incorrect because while they are potential side effects of topotecan, they are usually not as immediately concerning as a sore throat, which could signal a serious infection requiring prompt attention.

4. A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.

5. A client with Graves' disease is being taught about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heart rate.
• D. Propranolol promotes a decrease in thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that helps decrease heart rate and control tremors in individuals with Graves' disease. It does not increase blood flow to the thyroid gland (choice A), prevent excess glucose in the blood (choice B), or directly decrease thyroid hormone levels in the body (choice D). Propranolol's primary role in Graves' disease is to alleviate symptoms like tremors and fast heart rate by blocking the effects of excessive thyroid hormone, rather than reducing the actual levels of thyroid hormone in the body.

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