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 is being discharged with a new prescription for Fluoxetine for PTS. Which of the following statements should the nurse include in the teaching?

• A. You may experience a decreased desire for intimacy while taking this medication.
• B. You should take this medication in the morning to avoid sleep disturbances.
• C. To minimize urinary adverse effects, ensure you urinate before taking this medication.
• D. It is recommended to wear sunglasses outdoors due to the light sensitivity caused by this medication.

Correct answer: A

Rationale: The correct statement for the nurse to include in the teaching is that the client may experience a decreased desire for intimacy while taking Fluoxetine for PTS. This is important because Fluoxetine, an SSRI used to treat PTS, can lead to decreased libido as a potential adverse effect. Choices B, C, and D are incorrect because they do not address the specific side effect associated with Fluoxetine and are not directly relevant to the medication's effects for this patient.

3. A client has been prescribed Prednisone for an inflammatory condition and is receiving discharge teaching from a nurse. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Avoid alcohol while taking this medication.
• C. Monitor your blood pressure regularly.
• D. Take this medication in the morning to prevent insomnia.

Correct answer: D

Rationale: The correct answer is to take Prednisone in the morning to prevent insomnia. Prednisone can cause insomnia as a side effect, so taking it in the morning can help minimize this issue. It is important to follow the healthcare provider's instructions regarding the timing of Prednisone administration to optimize its effectiveness and minimize adverse effects.

4. A patient is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin?

• A. Hemoglobin
• B. Prothrombin time (PT)
• C. Bleeding time
• D. Activated partial thromboplastin time (aPTT)

Correct answer: B

Rationale: The correct answer is to monitor Prothrombin time (PT) when a patient is on warfarin therapy. Warfarin affects blood clotting, and PT is used to assess the therapeutic effect of this medication. Hemoglobin (Choice A) is not directly affected by warfarin therapy and does not reflect its therapeutic effect. Bleeding time (Choice C) measures the time it takes for bleeding to stop after a standardized cut and is not specific to warfarin therapy. Activated partial thromboplastin time (aPTT) (Choice D) is more commonly used to monitor heparin therapy, not warfarin.

5. A client has a new prescription for Metoprolol to treat hypertension. Which of the following instructions should the nurse include?

• A. Stop taking the medication if your heart rate is below 70/min.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Increase your fluid intake while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client starting Metoprolol is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, leading to dizziness and falls if the client changes positions quickly. By advising the client to make position changes slowly, the nurse helps prevent these adverse effects and promotes safety.

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