Nursing Elites

1. A client is prescribed clonidine 0.1 mg/24 hours via a transdermal patch. Which client outcome would indicate that the medication is effective?

• A. No complaints of recent episodes of angina
• B. Change in peripheral edema from +3 to +1
• C. No complaints of new onset of nausea or vomiting
• D. Blood pressure changes from 180/120 to 140/70 mm Hg

Correct answer: D

Rationale: Clonidine is an antihypertensive agent that works centrally to reduce blood pressure. A significant decrease in blood pressure, such as changing from 180/120 to 140/70 mm Hg, indicates that the medication is effectively managing hypertension. Monitoring blood pressure levels is crucial in assessing the response to clonidine therapy. Choices A, B, and C are incorrect as they do not directly relate to the therapeutic effect of clonidine in managing hypertension, which is the primary goal of the medication in this scenario.

2. A client with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. The nurse should assess the client for which potential side effect?

• A. Nausea
• B. Dry mouth
• C. Cough
• D. Palpitations

Correct answer: B

Rationale: The correct answer is B: Dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. Anticholinergic medications like ipratropium can lead to decreased salivary flow, resulting in dry mouth. Choices A, C, and D are incorrect because nausea, cough, and palpitations are not commonly associated with ipratropium use.

3. An adolescent client with a seizure disorder is prescribed the anticonvulsant medication carbamazepine. The nurse should notify the healthcare provider if the client develops which condition?

• A. Experiences dry mouth.
• B. Experiences dizziness.
• C. Develops a sore throat.
• D. Develops gingival hyperplasia.

Correct answer: C

Rationale: The correct answer is C: 'Develops a sore throat.' When a client on carbamazepine develops flu-like symptoms such as pallor, fatigue, sore throat, and fever, it could indicate blood dyscrasias (aplastic anemia, leukopenia, anemia, thrombocytopenia), which are potential adverse effects of the medication. These symptoms warrant immediate notification of the healthcare provider for further evaluation and management to prevent complications. Choices A, B, and D are incorrect because dry mouth, dizziness, and gingival hyperplasia are not commonly associated with carbamazepine use and do not indicate serious adverse effects that require immediate healthcare provider notification.

4. A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the desired effect of this medication has been achieved?

• A. Dependent edema reduced from +3 to +1.
• B. Serum HDL increased from 35 to 55 mg/dL.
• C. Pulse rate reduced from 150 to 90 beats/min.
• D. Blood pressure reduced from 160/90 to 130/80 mm Hg.

Correct answer: D

Rationale: The correct answer is D. Losartan is prescribed for the treatment of hypertension. The desired effect of losartan is to reduce blood pressure. Therefore, a reduction in blood pressure from 160/90 to 130/80 mm Hg indicates that the desired effect of the medication has been achieved. Choices A, B, and C are not specific effects of losartan and do not directly relate to the expected outcomes of this medication. Dependent edema, serum HDL levels, and pulse rate are not typically influenced by losartan, making choices A, B, and C incorrect.

5. In a capillary glucose measurement, a client is to receive 10 units of regular insulin and isophane insulin. How should the nurse prepare?

• A. Withdraw ten units of regular insulin from a vial
• B. Withhold the dose until regular insulin is available
• C. Obtain a new vial of regular insulin and withhold
• D. Pull up 30 units from a vial but only administer 10 units

Correct answer: B

Rationale: In insulin administration, regular insulin is typically administered before isophane insulin to manage blood glucose effectively. If regular insulin is not available, it is best to withhold the dose until it can be administered as prescribed. Choice A is incorrect as it suggests withdrawing from a specific vial without specifying regular insulin. Choice C is incorrect as obtaining a new vial of regular insulin may not be necessary if it becomes available shortly. Choice D is incorrect as administering 10 units from a mixture of regular and isophane insulin is not the correct approach.

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