Nursing Elites

1. A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?

• A. A headache indicates a serious allergic reaction to nitroglycerin.
• B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
• C. Nitroglycerin does not cause a headache.
• D. The most common side effect of nitroglycerin is a headache.

Correct answer: D

Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.

2. A client with a new prescription for an antihypertensive medication is being provided discharge instructions by a nurse. Which of the following statements should the nurse give?

• A. Be sure to limit your potassium intake while taking the medication.
• B. You should check your blood pressure every 8 hours while taking this medication.
• C. Your medication dosage will be increased if you develop tachycardia.
• D. Change positions slowly when you move from sitting to standing.

Correct answer: D

Rationale: The correct statement for the nurse to provide is to instruct the client to change positions slowly when moving from sitting to standing. This is crucial because antihypertensive medications can cause orthostatic hypotension, leading to dizziness or lightheadedness when changing positions quickly. Checking blood pressure every 8 hours is unnecessary and could lead to over-monitoring. There is no direct relationship between the medication and potassium intake. Increasing the medication dosage due to tachycardia is not a typical response and may not be accurate.

3. A client has a prescription for Erythromycin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Expect your urine to turn dark yellow.
• C. Take the medication with a full glass of milk.
• D. Report persistent diarrhea to your provider.

Correct answer: D

Rationale: The correct answer is D: 'Report persistent diarrhea to your provider.' Erythromycin is known to cause Clostridium difficile-associated diarrhea, which can be severe. Instructing the client to report any persistent diarrhea to their healthcare provider promptly is crucial to prevent complications. Choices A, B, and C are incorrect. Taking Erythromycin with food is generally recommended to reduce stomach upset, but it is not the most critical instruction. Expecting urine to turn dark yellow is not a common side effect of Erythromycin. Taking Erythromycin with a full glass of milk is not necessary and may not be appropriate for all clients, especially those with lactose intolerance or dairy allergies.

4. A patient states he experiences anxiety and has panic attacks at least once a week. What might be helpful for this patient?

• A. Phenytoin (Dilantin)
• B. Lithium
• C. Alprazolam (Xanax)
• D. Spironolactone

Correct answer: C

Rationale: Alprazolam (Xanax) is a medication commonly prescribed to treat anxiety disorders and panic attacks. It belongs to the class of medications known as benzodiazepines, which work by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain to produce a calming effect. Phenytoin is an antiepileptic drug, not typically used for anxiety or panic attacks. Lithium is primarily used to treat bipolar disorder, not anxiety. Spironolactone is a diuretic primarily used to treat conditions like high blood pressure and heart failure, not anxiety or panic attacks.

5. A client is receiving treatment with etoposide. Which of the following findings should the nurse monitor?

• A. Hypotension
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypertension

Correct answer: A

Rationale: Etoposide is associated with hypotension as a common adverse effect. Therefore, the nurse should closely monitor the client for signs and symptoms of hypotension while receiving this medication, such as dizziness, light-headedness, or low blood pressure readings. Prompt recognition and management of hypotension can help prevent complications and ensure the client's safety during treatment with etoposide.

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