Nursing Elites

1. When starting amitriptyline, a client should be instructed to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Urinary retention
• C. Bradycardia
• D. Dry cough

Correct answer: B

Rationale: When a client starts taking amitriptyline, an important adverse effect to monitor for is urinary retention. Amitriptyline is a tricyclic antidepressant that can cause anticholinergic effects, including urinary retention. It is crucial to educate the client on recognizing and reporting this adverse effect to their healthcare provider. Diarrhea is not a common adverse effect of amitriptyline and is more associated with other medications. Bradycardia is a possible adverse effect of amitriptyline, but urinary retention is a more common and significant concern. Dry cough is not a typical adverse effect of amitriptyline.

2. A client has a prescription for Timolol eye drops for the treatment of glaucoma. Which of the following instructions should the nurse include?

• A. Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application.
• B. Avoid blinking immediately after instilling the drops.
• C. Keep your eyes closed for 5 minutes after application.
• D. Administer the drops directly onto the cornea.

Correct answer: A

Rationale: The correct instruction for the nurse to include is to apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application. This technique helps prevent systemic absorption of the medication, reducing the risk of systemic side effects. By applying pressure, the drainage of the medication into the bloodstream through the nasolacrimal duct is minimized, enhancing the drug's local ocular effects. Choices B, C, and D are incorrect because blinking immediately after instilling the drops, keeping eyes closed for 5 minutes, and administering the drops directly onto the cornea are not recommended practices for administering Timolol eye drops.

3. A client has a new prescription for Sulfasalazine for the treatment of Crohn's disease. Which of the following instructions should the nurse include?

• A. Expect orange-yellow discoloration of urine and skin.
• B. Take the medication with food.
• C. Do not discontinue the medication if a sore throat occurs.
• D. Avoid prolonged exposure to sunlight.

Correct answer: A

Rationale: The correct answer is A: 'Expect orange-yellow discoloration of urine and skin.' Sulfasalazine can cause this harmless side effect, which does not require discontinuation of the medication. Option B is incorrect because Sulfasalazine is usually taken with food to minimize gastrointestinal side effects. Option C is incorrect as a sore throat is not a common reason to stop the medication. Option D is not directly related to the side effects of Sulfasalazine.

4. A client has a new prescription for combination oral NRTIs for the treatment of HIV. Which of the following statements should the nurse include in discharge teaching?

• A. These medications work by inhibiting enzymes to prevent HIV replication.
• B. These medications work by preventing protein synthesis within the HIV cell.
• C. These medications work by weakening the cell wall of the HIV virus.
• D. These medications work by blocking HIV entry into cells.

Correct answer: A

Rationale: The correct answer is A. NRTI antiretroviral medications inhibit the enzyme reverse transcriptase, which is essential for HIV replication. By blocking this enzyme, the medications prevent the virus from replicating and spreading. This mechanism of action helps to control the progression of HIV infection in the body. Choices B, C, and D are incorrect because NRTIs do not work by preventing protein synthesis, weakening the cell wall of the virus, or blocking HIV entry into cells. These mechanisms are associated with different classes of antiretroviral medications used in HIV treatment.

5. A healthcare provider is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the healthcare provider use to elicit the child's cooperation?

• A. Offer the child a choice of taking the medication with juice or water
• B. Tell the child it is candy
• C. Hide the medication in a large dish of ice cream
• D. Tell the child they will have a shot instead

Correct answer: A

Rationale: Offering children choices empowers them and can help in gaining cooperation, especially when it comes to taking medications. By providing options like taking the medication with juice or water, the child feels a sense of control and may be more willing to cooperate. This approach respects the child's autonomy and can make the experience more positive for both the child and the healthcare provider. Choices B, C, and D are not ideal strategies as they involve deception or coercion, which can lead to distrust and make the child more resistant to taking medication in the future.

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