Nursing Elites

1. A client has a new prescription for hydrochlorothiazide. The client should monitor for which of the following adverse effects?

• A. Hyponatremia
• B. Ototoxicity
• C. Hypoglycemia
• D. Hyperkalemia

Correct answer: A

Rationale: Hyponatremia is a potential adverse effect of hydrochlorothiazide due to its diuretic action. Hydrochlorothiazide is a thiazide diuretic that can cause sodium and water loss, potentially leading to hyponatremia. Monitoring for symptoms such as weakness, confusion, and muscle cramps can help detect hyponatremia early. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) is not typically associated with hydrochlorothiazide use. Hyperkalemia (choice D) is more commonly associated with potassium-sparing diuretics rather than thiazide diuretics like hydrochlorothiazide.

2. A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

• A. Document that the client experienced an anaphylactic reaction to the medication.
• B. Change the IV infusion site.
• C. Decrease the infusion rate on the IV.
• D. Apply cold compresses to the neck area.

Correct answer: C

Rationale: Flushing and tachycardia are signs of Red Man Syndrome, which can be mitigated by decreasing the infusion rate.

3. A client has been prescribed Atorvastatin to lower cholesterol. Which of the following instructions should the nurse include?

• A. Take this medication with a full glass of water.
• B. Report any muscle pain to your provider immediately.
• C. Avoid drinking grapefruit juice while taking this medication.
• D. Take this medication at bedtime to prevent drowsiness.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to 'Report any muscle pain to your provider immediately.' Muscle pain can be a sign of rhabdomyolysis, a rare but serious side effect of statins like atorvastatin. It is crucial to monitor for potential complications, and reporting muscle pain promptly can lead to timely intervention if needed. Choices A, C, and D are incorrect because they do not address a critical side effect of atorvastatin or provide essential information for the client's safety and well-being.

4. When discussing immunizations, which vaccine series is typically completed before a child's first birthday?

• A. Pneumococcal conjugate vaccine
• B. Meningococcal conjugate vaccine
• C. Varicella vaccine
• D. Rotavirus vaccine

Correct answer: D

Rationale: The correct answer is D, Rotavirus vaccine. The rotavirus vaccine series is usually completed before a child's first birthday. It is given to infants in a series of doses starting at 2 months of age and must be completed by 8 months of age. This vaccine helps protect against severe diarrhea and vomiting caused by rotavirus infection, which is common in infants and young children. Choices A, B, and C are incorrect because the Pneumococcal conjugate vaccine, Meningococcal conjugate vaccine, and Varicella vaccine are not typically completed before a child's first birthday.

5. A client is prescribed an IM dose of penicillin. She reports developing a rash after taking penicillin 3 years ago. What action should the healthcare professional take?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. It is crucial to report any past allergic reactions to medications, as this information guides the provider in prescribing a safe alternative. Administering the prescribed dose without considering the client's history of developing a rash can lead to potentially severe adverse reactions. Changing the prescription to an oral form or administering an oral antihistamine does not address the risk of an allergic reaction to penicillin in this case.

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