Nursing Elites

1. A client diagnosed with multiple sclerosis self-administers beta-1 interferon subcutaneously

• A. Explain to the client that the medication dose may need to be increased
• B. Instruct the client to withhold the drug until the next exacerbation
• C. Advise the client to consult the healthcare provider as soon as possible
• D. Encourage the client to continue taking the medication

Correct answer: D

Rationale: Encouraging the client to continue taking the medication is crucial in the management of multiple sclerosis. Beta-1 interferon is a disease-modifying drug used to reduce the frequency and severity of relapses in multiple sclerosis. Discontinuing the medication without medical advice can lead to disease exacerbation. It is essential for the client to maintain regular dosing to achieve optimal therapeutic effects and disease control.

2. A client receiving enalapril reports a persistent dry cough. The nurse should explain that this side effect is related to which medication action?

• A. It reduces the production of angiotensin II.
• B. It increases the production of angiotensin II.
• C. It causes increased production of bradykinin.
• D. It increases the production of aldosterone.

Correct answer: C

Rationale: The correct answer is C. Enalapril, an ACE inhibitor, inhibits the conversion of angiotensin I to angiotensin II, leading to increased levels of bradykinin. The accumulation of bradykinin is responsible for the persistent dry cough associated with ACE inhibitors like enalapril. Choices A, B, and D are incorrect because enalapril does not directly affect the production of angiotensin II or aldosterone. Instead, it primarily impacts the renin-angiotensin-aldosterone system by inhibiting the conversion of angiotensin I to angiotensin II, leading to bradykinin accumulation.

3. A healthy 68-year-old client asks the practical nurse (PN) whether they should take the pneumococcal vaccine. Which statement should the PN offer to the client that provides the most accurate information about this vaccine?

• A. The vaccine is given annually before the flu season to those older than 50 years.
• B. The immunization is recommended for children younger than 2 years old and all adults 65 years or older.
• C. The vaccine is for all ages and is given primarily to those traveling overseas to areas of infection.
• D. The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years.

Correct answer: B

Rationale: The correct answer is B because it is usually recommended that children younger than 2 years old and adults 65 years or older get vaccinated against pneumococcal disease. This is because these age groups are more susceptible to severe complications from the infection. While the vaccine may be recommended for certain individuals with specific medical conditions at any age, the primary target groups are as mentioned in option B. Option A is incorrect as the pneumococcal vaccine is not given annually like the flu vaccine. Option C is incorrect because the vaccine is not primarily for travelers but for certain age groups and individuals with medical conditions at risk. Option D is incorrect as the vaccine's duration of protection can vary, and it is not guaranteed to prevent pneumococcal pneumonia for up to 5 years.

4. A client with hypertension is prescribed atenolol. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Dry mouth
• D. Hypotension

Correct answer: A

Rationale: When a client is prescribed atenolol, a beta-blocker, the nurse should monitor for bradycardia, which is a potential side effect. Atenolol works by slowing the heart rate, so monitoring the client's heart rate is essential to detect and manage bradycardia promptly.

5. A client with a diagnosis of schizophrenia is prescribed risperidone. The nurse should monitor for which potential side effect?

• A. Weight gain
• B. Tremors
• C. Insomnia
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Weight gain. When a client is prescribed risperidone, monitoring weight is crucial due to the potential side effect of weight gain associated with this medication. This side effect can be significant as it may lead to other health issues. Choice B, Tremors, is not typically associated with risperidone use. Choice C, Insomnia, is less likely to be a direct side effect of risperidone compared to weight gain. Choice D, Hyperglycemia, is a possible side effect of some antipsychotic medications, but it is not commonly associated with risperidone.

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