Nursing Elites

1. A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before leaving the hospital. How should the PN respond to this client's request?

• A. Determine if a take-home prescription for hydrocodone was provided and, if so, tell him to take one of them.
• B. Encourage him to wait until he is at home to take a medication that might impair reasoning.
• C. Give him a tablet from the hospital stock and tell him to wait until he is almost home to take it.
• D. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10.

Correct answer: D

Rationale: Hydrocodone is a narcotic analgesic, and the practical nurse should gather more data from the client about the pain he is experiencing before giving the medication. The client's need for pain medication should be addressed, and pain medication should not be withheld because he is going home.

2. A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?

• A. Avoid using artificial tears because they decrease the efficacy of cyclosporine.
• B. Discontinue the use of both products if transient blurring occurs after administration.
• C. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
• D. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level.

Correct answer: C

Rationale: The correct answer is to allow a 15-minute interval between the administration of cyclosporine and artificial tears. Cyclosporine, an ophthalmic emulsion that increases tear production, can be used in conjunction with artificial tears as long as the products are administered 15 minutes apart. This interval helps to prevent any potential interactions between the two products and ensures optimal effectiveness of cyclosporine for treating dry eyes.

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

• A. Bleeding
• B. Bruising
• C. Nausea
• D. Headache

Correct answer: A

Rationale: Clopidogrel is an antiplatelet medication that works to prevent blood clots, but it can also increase the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, or unusual bleeding from the gums. Prompt identification and management of bleeding are crucial to prevent complications. Choices B, C, and D are incorrect because while bruising and other symptoms can occur as a result of bleeding, they are not the primary side effect to monitor for with clopidogrel. Nausea and headache are less commonly associated with clopidogrel use compared to bleeding.

4. When a client with hypertension is prescribed losartan, what potential side effect should the nurse monitor for?

• A. Hyperkalemia
• B. Dry cough
• C. Bradycardia
• D. Headache

Correct answer: B

Rationale: The correct answer is B: Dry cough. Losartan, an angiotensin II receptor blocker, can lead to a dry cough as a potential side effect. This occurs due to the drug's effect on the bradykinin pathway in the lungs. Monitoring for a dry cough is essential as it may indicate the need for further evaluation or medication adjustment to manage this adverse reaction.

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

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

Correct answer: A

Rationale: When a client with a history of stroke is prescribed clopidogrel, the nurse should monitor for potential side effects, especially bleeding. Clopidogrel is an antiplatelet medication that works by preventing blood clots. One of the major risks associated with clopidogrel is an increased tendency to bleed. Therefore, monitoring for signs of bleeding, such as easy bruising, blood in stool or urine, or prolonged bleeding from minor cuts, is crucial to ensure patient safety and early intervention if needed.

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