Nursing Elites

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

• A. Hyponatremia
• B. Agranulocytosis
• C. Liver toxicity
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A, Hyponatremia. Oxcarbazepine, an anticonvulsant used in bipolar disorder, can lead to hyponatremia. This is because it can cause the body to retain water, leading to a dilution of sodium levels in the blood. Monitoring sodium levels is crucial to prevent complications such as confusion, seizures, and even coma. Choices B, C, and D are incorrect. Agranulocytosis is not typically associated with oxcarbazepine use. Liver toxicity is a potential adverse effect of some medications but not commonly seen with oxcarbazepine. While weight gain can be a side effect of certain medications used in bipolar disorder treatment, it is not a common adverse effect of oxcarbazepine.

2. What instruction should the nurse include in the teaching plan for a client prescribed ranitidine for a peptic ulcer?

• A. Take this medication in the morning before breakfast.
• B. Take this medication with meals.
• C. Avoid taking this medication with antacids.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client prescribed ranitidine for a peptic ulcer is to take the medication in the morning before breakfast. This timing helps reduce stomach acid production throughout the day, providing optimal therapeutic effects. Option B is incorrect because taking ranitidine with meals is not the recommended timing. Option C is incorrect as there is no specific contraindication against taking ranitidine with antacids. Option D is incorrect as the medication should not be taken at bedtime but rather in the morning before breakfast.

3. A client is prescribed cyclobenzaprine for muscle spasms. The nurse should instruct the client to avoid which substance while taking this medication?

• A. Alcohol
• B. Caffeine
• C. Nicotine
• D. Dairy products

Correct answer: A

Rationale: The correct answer is A: Alcohol. When taking cyclobenzaprine, it is important to avoid alcohol as it can potentiate the central nervous system depressant effects of the medication. This interaction can lead to increased drowsiness, dizziness, and impaired coordination. Therefore, it is essential for the client to refrain from alcohol consumption while on cyclobenzaprine to prevent these adverse effects and ensure their safety. Choices B, C, and D are incorrect because caffeine, nicotine, and dairy products do not have significant interactions with cyclobenzaprine. While caffeine and nicotine may have stimulant effects that could theoretically counteract some of the sedative effects of cyclobenzaprine, they are not contraindicated. Dairy products, on the other hand, do not interact with cyclobenzaprine and can be consumed safely.

4. Phenytoin is prescribed for a client who has a seizure disorder. Which statement by the client needs to be clarified by the healthcare provider?

• A. I should notify the healthcare provider if the color of my urine turns pink.
• B. I should never stop taking this medication abruptly.
• C. I should monitor my glucose levels closely since I am diabetic.
• D. I should take the medicine with antacids if gastric upset occurs.

Correct answer: D

Rationale: The correct answer is D because antacids should not be taken with phenytoin as they can decrease its effects. Taking antacids with phenytoin is not recommended. Choice A is correct; pink discoloration of urine can occur with phenytoin use. Choice B is also correct; abruptly stopping phenytoin can lead to seizures. Choice C is correct; monitoring glucose levels is important as phenytoin can increase glucose levels. Therefore, the statement about using antacids with phenytoin needs clarification.

5. A 43-year-old female client who has had a thyroidectomy due to Grave's disease is prescribed a thyroid replacement hormone. Which signs and symptoms are associated with thyroid hormone toxicity and should be reported promptly to the healthcare provider?

• A. Tinnitus and dizziness
• B. Tachycardia and chest pain
• C. Dry skin and intolerance to cold
• D. Weight gain and increased appetite

Correct answer: B

Rationale: The correct answer is B: Tachycardia and chest pain. Signs and symptoms of thyroid hormone toxicity, especially in cases of excessive dosage, include tachycardia (rapid heart rate) and chest pain. These symptoms are consistent with hyperthyroidism, where the body is receiving an excessive amount of thyroid hormone. It is crucial to report these symptoms promptly to the healthcare provider to adjust the medication dosage and prevent potential complications. Choices A, C, and D are not indicative of thyroid hormone toxicity. Tinnitus and dizziness (Choice A) are not typical symptoms of thyroid hormone toxicity. Dry skin and intolerance to cold (Choice C) are more common in hypothyroidism, while weight gain and increased appetite (Choice D) are associated with hypothyroidism as well, not thyroid hormone toxicity.

Similar Questions