Nursing Elites

1. A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?

• A. Take the medication at the same time every day.
• B. Discontinue the medication if a rash develops.
• C. Avoid consuming dairy products.
• D. Monitor blood pressure regularly.

Correct answer: A

Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin. Choices B, C, and D are incorrect because discontinuing the medication without healthcare provider guidance can be dangerous, there is no specific interaction between phenytoin and dairy products, and monitoring blood pressure is not a primary concern with phenytoin therapy for seizures.

2. An older adult with iron deficiency anemia is being discharged with iron supplements, which information should the nurse include in the discharge?

• A. Take the tablet with a daily multivitamin
• B. Crush the tablet and mix it with pudding
• C. Bedtime is the best time to take the tablet
• D. Wait 2 hours after meals to take the tablet

Correct answer: D

Rationale: The correct answer is to wait 2 hours after meals before taking the iron tablet. This is important to ensure better absorption and efficacy of the iron supplement. Taking the tablet with a daily multivitamin (Choice A) may interfere with iron absorption due to interactions with other minerals. Crushing the tablet and mixing it with pudding (Choice B) can alter the effectiveness of the medication. While bedtime (Choice C) may be convenient, waiting after meals is crucial for optimal iron absorption.

3. A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?

• A. Increased appetite
• B. Dry mouth and increased thirst
• C. Tremors and polyuria
• D. Constipation

Correct answer: B

Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.

4. A client with a history of stroke is prescribed warfarin. The nurse should monitor for which potential side effect?

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Bleeding. Warfarin is an anticoagulant medication that works by thinning the blood. One of the potential side effects of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as unusual bruising, blood in the urine or stool, or prolonged bleeding from cuts or gums. Prompt recognition and management of bleeding are essential to prevent complications. Choices B, C, and D are incorrect as weight gain, headache, and dizziness are not common side effects of warfarin. Monitoring for bleeding is a priority due to the anticoagulant properties of warfarin.

5. 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.

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