Nursing Elites

1. When educating a client with a new prescription for Enalapril, which manifestation should the nurse instruct the client to report as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors, such as enalapril. This cough can be bothersome and may indicate the need for a medication adjustment. It is crucial for the client to report this symptom to their healthcare provider to explore potential alternatives or adjustments to the treatment plan. Tremors, drowsiness, and hyperactivity are not commonly associated with enalapril and are less likely to be attributed to this medication.

2. A client who takes Chlorpromazine for the treatment of Schizophrenia is due for a follow-up assessment. The nurse should expect the greatest improvement in which of the following manifestations? (Select all that apply.)

• A. Disorganized speech.
• B. Bizarre behavior.
• C. Impaired social interactions.
• D. Hallucinations.

Correct answer: A

Rationale: When a client takes a conventional antipsychotic medication like chlorpromazine, the greatest improvement is typically seen in positive symptoms such as disorganized speech. These medications are more effective in managing positive symptoms like disorganized speech rather than negative symptoms like impaired social interactions or hallucinations. Therefore, the nurse should anticipate improvement in disorganized speech as a positive response to chlorpromazine treatment.

3. A nurse is providing discharge instructions to a client who has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a hairy area.
• B. Change the patch every 24 hours.
• C. Avoid exposure to heat sources.
• D. Cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction that the nurse should include when providing discharge instructions for a client with a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, leading to a risk of overdose. Choice A is incorrect because the patch should be applied to a clean, non-hairy area. Choice B is incorrect as the Fentanyl patch is usually changed every 72 hours, not every 24 hours. Choice D is incorrect as the patch should never be cut to adjust the dosage.

4. What is a common side effect that typically occurs with the initial therapy of Nitroglycerine as a result of increased vasodilation?

• A. Abdominal cramps
• B. Calf pain
• C. Headache
• D. Blurred vision

Correct answer: C

Rationale: Headache is a common side effect associated with the initial therapy of Nitroglycerine due to its vasodilatory properties. The vasodilation caused by Nitroglycerine leads to relaxation of blood vessels, including those in the head, which can result in headaches. This side effect is considered normal and is often transient, diminishing with continued use of the medication.

5. When teaching a client with a new prescription for Furosemide, which instruction should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction for a client with a new prescription for Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these potential adverse effects. Choices A, B, and D are incorrect. Taking Furosemide at bedtime (Choice A) is not necessary as it can be taken at any time of the day. Avoiding foods high in potassium (Choice B) is more relevant for clients taking potassium-sparing diuretics. Taking Furosemide with meals (Choice D) may lead to increased diuretic effects and frequent urination.

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