Nursing Elites

1. A client admitted with shortness of breath and palpitations currently takes an antiarrhythmic medication, dronedarone. Which action should the nurse take to prevent arrhythmias?

• A. Measure orthostatic blood pressure
• B. Obtain a 12-lead ECG reading daily
• C. Assess the client's apical pulse daily
• D. Provide continuous ECG monitoring

Correct answer: D

Rationale: The correct action to prevent arrhythmias in a client taking an antiarrhythmic medication like dronedarone is to provide continuous ECG monitoring. This is essential because antiarrhythmic drugs can sometimes cause pro-arrhythmic effects, which may lead to dangerous heart rhythm disturbances. Continuous ECG monitoring allows for real-time detection of any abnormal rhythms, enabling prompt intervention. Measuring orthostatic blood pressure, obtaining a 12-lead ECG reading daily, and assessing the client's apical pulse daily are important assessments in general patient care but may not specifically prevent arrhythmias in this scenario.

2. A patient with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to light and a dry mouth. How should the nurse respond?

• A. Determine if the medication is being taken correctly
• B. Provide instructions on managing these side effects
• C. Schedule an appointment for evaluation by the healthcare provider
• D. Advise stopping the medication until the unpleasant side effects wear off

Correct answer: B

Rationale: The correct response is to provide instructions on managing these side effects. Sensitivity to light and dry mouth are common side effects of anticholinergic medications like dicyclomine. It is essential for the nurse to educate the patient on strategies to cope with these side effects, such as staying hydrated to address dry mouth and wearing sunglasses to reduce sensitivity to light. Option A is not the priority as the side effects are expected with this medication and do not necessarily indicate incorrect use. Option C is not immediately necessary as the side effects are common and can be managed without a healthcare provider evaluation. Option D is not recommended unless advised by the healthcare provider as abruptly stopping the medication can lead to worsening symptoms or withdrawal effects.

3. A client with chronic kidney disease is prescribed cinacalcet. The nurse should monitor for which potential side effect?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hyperkalemia
• D. Hyperphosphatemia

Correct answer: A

Rationale: Corrected Rationale: Cinacalcet is a medication that can lower calcium levels, leading to hypocalcemia. Monitoring for signs of low calcium levels such as muscle cramps, tingling sensations, and abnormal heart rhythms is crucial to prevent complications in clients with chronic kidney disease.\nIncorrect Choices Rationale: B) Hypercalcemia is the opposite effect of cinacalcet; C) Hyperkalemia and D) Hyperphosphatemia are not typically associated with cinacalcet use.

4. A practical nurse (PN) is preparing to administer a scheduled dose of furosemide to a client. Which laboratory value is most important for the PN to review before administering the medication?

• A. Serum calcium level
• B. Serum potassium level
• C. Serum sodium level
• D. Serum magnesium level

Correct answer: B

Rationale: The correct answer is to review the client's serum potassium level before administering furosemide. Furosemide, a loop diuretic, can lead to hypokalemia, making it crucial to assess potassium levels to prevent potential complications like cardiac arrhythmias associated with low potassium levels.

5. A client is prescribed ondansetron for nausea and vomiting. The nurse should monitor the client for which potential adverse effect?

• A. Headache
• B. Diarrhea
• C. Constipation
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Constipation. Ondansetron is known to cause constipation as a potential adverse effect. It is important for the nurse to monitor the client for constipation while on this medication to address any issues promptly. Choices A, B, and D are incorrect because headache, diarrhea, and increased appetite are not common adverse effects associated with ondansetron.

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