Nursing Elites

1. A client is prescribed methylprednisolone for an allergic reaction. The nurse should monitor for which potential side effect of this medication?

• A. Nausea and vomiting
• B. Weight gain
• C. Insomnia
• D. Increased appetite

Correct answer: B

Rationale: When a client is prescribed methylprednisolone, a corticosteroid, the nurse should monitor for weight gain as a potential side effect. Corticosteroids like methylprednisolone can cause weight gain and fluid retention due to their impact on metabolism and sodium retention. Nausea and vomiting are less common side effects of methylprednisolone. Insomnia and increased appetite are not typically associated with methylprednisolone use.

2. A client with a history of hypertension is prescribed hydrochlorothiazide. The practical nurse should monitor the client for which potential adverse effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: B

Rationale: Corrected Rationale: Hydrochlorothiazide is a diuretic that can lead to potassium loss, resulting in hypokalemia. Monitoring for hypokalemia is essential because it can cause various complications such as cardiac dysrhythmias. Therefore, the practical nurse should closely watch for signs and symptoms of low potassium levels in clients taking hydrochlorothiazide. Incorrect Rationale for Other Choices: A. Hyperkalemia is not typically associated with hydrochlorothiazide use; instead, it is more commonly linked to medications like ACE inhibitors or potassium-sparing diuretics. C. Hypernatremia is unlikely with hydrochlorothiazide use as it tends to cause sodium loss. D. Hyponatremia is more commonly associated with conditions where there is excessive water intake or syndrome of inappropriate antidiuretic hormone secretion (SIADH), rather than with hydrochlorothiazide use.

3. 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.

4. A client with rheumatoid arthritis is prescribed methotrexate. The nurse should monitor for which common side effect of this medication?

• A. Liver toxicity
• B. Skin rash
• C. Hair loss
• D. Abdominal pain

Correct answer: A

Rationale: The correct answer is A: Liver toxicity. Methotrexate is known to cause liver toxicity, making regular monitoring of liver function essential. Monitoring liver function tests helps detect any signs of liver damage early, allowing for appropriate interventions to be implemented promptly.

5. A client with rheumatoid arthritis is prescribed methotrexate. What is the most important instruction the practical nurse (PN) should provide to the client?

• A. Take the medication on an empty stomach.
• B. Avoid taking folic acid supplements.
• C. Report any signs of infection immediately.
• D. Increase intake of vitamin C-rich foods.

Correct answer: C

Rationale: Correct Answer: The most important instruction for a client taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. Early detection and treatment of infections are crucial to prevent complications. Instructing the client to be vigilant for signs of infection empowers them to take prompt action, enhancing their overall safety and well-being.

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