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 healthcare professional is educating a client about the adverse effects of Metformin. Which of the following adverse effects should the healthcare professional include?

• A. Lactic acidosis.
• B. Hypoglycemia.
• C. Hyperlipidemia.
• D. Weight gain.

Correct answer: A

Rationale: The correct answer is A: Lactic acidosis. Lactic acidosis is a rare but severe side effect of Metformin, particularly in individuals with renal or liver issues. It is crucial for clients taking Metformin to be aware of the symptoms of lactic acidosis, such as muscle pain, weakness, trouble breathing, stomach discomfort, and feeling cold. Choice B, hypoglycemia, is not a common adverse effect of Metformin but can occur when combined with other antidiabetic medications. Choice C, hyperlipidemia, is not a typical adverse effect of Metformin. Choice D, weight gain, is not associated with Metformin use; in fact, Metformin is often associated with weight loss or weight neutrality.

3. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: The nurse should expect that levothyroxine will be started at a low dose and gradually increased over several weeks. This cautious approach is crucial, especially in older adult clients, to prevent toxicity and ensure optimal therapeutic outcomes for managing hypothyroidism. Choice A is incorrect because starting at a high dose and tapering as needed is not the standard approach for levothyroxine. Choice B is incorrect because the initial dosage is typically adjusted to reach the optimal therapeutic dose. Choice C is incorrect as adjusting the dosage daily based on blood levels is not necessary for levothyroxine, as it has a long half-life and requires time to reach a steady state.

4. Which of the following is not a side effect of the vasodilator Nifedipine?

• A. Nausea
• B. Flushed appearance
• C. Vertigo
• D. Sexual dysfunction

Correct answer: D

Rationale: Sexual dysfunction is not a common side effect of vasodilators such as Nifedipine. Nausea, flushed appearance, and vertigo are more commonly reported side effects associated with this medication. It's essential for healthcare providers to be aware of the potential side effects to monitor and manage them effectively in patients prescribed with Nifedipine.

5. A client has a new prescription for Hydralazine. Which of the following side effects should the nurse instruct the client to monitor for and report?

• A. Orthostatic hypotension
• B. Increased heart rate
• C. Dark-colored urine
• D. Persistent cough

Correct answer: B

Rationale: Corrected Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia, leading to an increased heart rate. This side effect should be reported to the healthcare provider to ensure appropriate management and monitoring of the client's condition. Choice A (Orthostatic hypotension) is incorrect as Hydralazine is more likely to cause reflex tachycardia than orthostatic hypotension. Choice C (Dark-colored urine) and Choice D (Persistent cough) are unrelated to the common side effects of Hydralazine and should not be the focus of monitoring for this medication.

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