Nursing Elites

1. A client with a diagnosis of bipolar disorder is prescribed lamotrigine. The nurse should monitor for which potential adverse effect?

• A. Rash
• B. Tremors
• C. Hair loss
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Rash. Lamotrigine can cause a rash, which may indicate a serious adverse effect like Stevens-Johnson syndrome. Monitoring for a rash is crucial in clients taking lamotrigine to promptly address any potential severe reactions.

2. A client with rheumatoid arthritis is prescribed leflunomide. What instruction should the nurse include in the client's teaching plan?

• A. Avoid alcohol while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Avoid sunlight while taking this medication.
• D. Report any signs of infection to the healthcare provider.

Correct answer: A

Rationale: Leflunomide can increase sensitivity to sunlight. While it is important to avoid excessive sun exposure, the critical instruction for the client is to avoid alcohol while taking this medication. Alcohol can potentiate the hepatotoxic effects of leflunomide, making it crucial for the client to abstain from alcohol consumption to prevent liver damage.

3. A client with a history of heart failure is prescribed digoxin. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Hypertension
• D. Hypotension

Correct answer: A

Rationale: Digoxin, a medication commonly prescribed for heart failure, can lead to bradycardia, characterized by a slow heart rate. Monitoring for bradycardia is crucial to detect and manage this potential side effect early on to prevent complications such as arrhythmias or decreased cardiac output. Tachycardia (choice B) is not typically associated with digoxin use. Hypertension (choice C) and hypotension (choice D) are also not common side effects of digoxin.

4. A client with a history of deep vein thrombosis is prescribed rivaroxaban. The nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: When a client with a history of deep vein thrombosis is prescribed rivaroxaban, the nurse should monitor for signs of bleeding as rivaroxaban increases the risk of bleeding. Common adverse effects of rivaroxaban include bleeding events, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. It is crucial for the nurse to assess for these signs to prevent complications and ensure the client's safety. Choices B, C, and D are incorrect because rivaroxaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for bleeding is essential due to the anticoagulant properties of rivaroxaban.

5. An adolescent client with a seizure disorder is prescribed the anticonvulsant medication carbamazepine. The nurse should notify the healthcare provider if the client develops which condition?

• A. Experiences dry mouth.
• B. Experiences dizziness.
• C. Develops a sore throat.
• D. Develops gingival hyperplasia.

Correct answer: C

Rationale: The correct answer is C: 'Develops a sore throat.' When a client on carbamazepine develops flu-like symptoms such as pallor, fatigue, sore throat, and fever, it could indicate blood dyscrasias (aplastic anemia, leukopenia, anemia, thrombocytopenia), which are potential adverse effects of the medication. These symptoms warrant immediate notification of the healthcare provider for further evaluation and management to prevent complications. Choices A, B, and D are incorrect because dry mouth, dizziness, and gingival hyperplasia are not commonly associated with carbamazepine use and do not indicate serious adverse effects that require immediate healthcare provider notification.

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