Nursing Elites

1. 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.

2. A client with chronic kidney disease is prescribed sevelamer carbonate. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed sevelamer carbonate, the nurse should monitor for hypercalcemia as a potential side effect. Sevelamer carbonate can bind to dietary calcium and impair its absorption, potentially leading to elevated calcium levels in the blood. Monitoring calcium levels is crucial to detect and manage hypercalcemia promptly. Hypocalcemia (choice B) is incorrect because sevelamer carbonate's action is more likely to cause elevated calcium levels. Hyperkalemia (choice C) and hypokalemia (choice D) are related to potassium levels and are not typically associated with sevelamer carbonate use.

3. A client with a history of atrial fibrillation is prescribed apixaban. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: The correct answer is A: Bleeding. Apixaban is an anticoagulant medication that works by decreasing the blood's ability to clot. One of the significant side effects of apixaban is an increased risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in the urine or stool, or unusual bleeding or bruising. Monitoring for these signs is crucial to prevent or manage any potential complications associated with the medication. Choices B, C, and D are incorrect because weight gain, headache, and nausea are not typically associated with apixaban use. Therefore, the nurse should primarily focus on monitoring for signs of bleeding in a client prescribed apixaban.

4. A client with a diagnosis of schizophrenia is prescribed quetiapine. The nurse should monitor the client for which potential side effect?

• A. Weight gain
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: Quetiapine is known to cause weight gain as a common side effect. Monitoring the client's weight is crucial to identify any significant changes that may occur due to the medication.

5. A client with chronic heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an excess of potassium in the body, resulting in hyperkalemia. This side effect is important to monitor in clients taking spironolactone, especially those with chronic heart failure, as hyperkalemia can lead to serious cardiac complications.

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