Nursing Elites

1. An adolescent client has a new prescription for Clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of this medication?

• A. Wear sunglasses when outdoors.
• B. Check your temperature daily.
• C. Take this medication in the morning.
• D. Add extra calories to your diet.

Correct answer: A

Rationale: To minimize the adverse effect of photophobia associated with Clomipramine, the client should be advised to wear sunglasses when outdoors. Clomipramine is a tricyclic antidepressant (TCA) known to cause anticholinergic effects like photophobia, which can be reduced by protecting the eyes with sunglasses when exposed to bright light. Choices B, C, and D are incorrect because checking temperature daily, taking the medication in the morning, and adding extra calories to the diet are not specifically related to minimizing the adverse effect of photophobia caused by Clomipramine.

2. A healthcare professional is caring for a client who is receiving heparin therapy. Which of the following laboratory tests should the healthcare professional monitor to evaluate the therapeutic effect of heparin?

• A. PT/INR
• B. Platelet count
• C. aPTT
• D. WBC count

Correct answer: C

Rationale: The correct test to monitor the therapeutic effect of heparin is the activated partial thromboplastin time (aPTT). Heparin's action is to prolong the clotting time, and aPTT reflects this effect. Monitoring aPTT helps ensure that the client is within the therapeutic range to prevent clot formation while minimizing the risk of bleeding complications. PT/INR is used to monitor warfarin therapy, platelet count assesses for potential thrombocytopenia, and WBC count evaluates for signs of infection or inflammation, not the therapeutic effect of heparin.

3. A client is starting therapy with doxorubicin. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The correct answer is 'C: Sore throat.' Doxorubicin is known to have immunosuppressive effects, which can predispose the client to infections. A sore throat can be an early sign of infection, and prompt reporting to the healthcare provider is crucial to initiate appropriate interventions and prevent complications. Choices A, B, and D are incorrect because hair loss, fatigue, and red urine are common side effects of doxorubicin and are typically expected during therapy. While these side effects should be monitored, they do not require immediate reporting unless they become severe or concerning.

4. A client is starting therapy with filgrastim, and a nurse is providing teaching on monitoring adverse effects. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bone pain
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Bone pain. The nurse should instruct the client to monitor for bone pain since it is a common adverse effect of filgrastim. This occurs due to increased bone marrow activity stimulated by the medication.

5. A client with renal failure and an elevated phosphorus level is prescribed aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client?

• A. Constipation
• B. Metallic taste
• C. Headache
• D. Muscle spasms

Correct answer: A

Rationale: Correct. Aluminum hydroxide is known to cause constipation as a common side effect. Instructing the client about this potential adverse effect is important for their awareness and management. The other options, metallic taste, headache, and muscle spasms, are not typically associated with aluminum hydroxide use. Therefore, the nurse should focus on educating the client about the increased risk of constipation and provide guidance on managing this side effect to improve the client's comfort and treatment adherence.

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