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. Prior to administration of the initial dose of the GI agent misoprostol, which information should the nurse obtain from the client?

• A. Taking an anti-emetic medication
• B. History of glaucoma
• C. Currently pregnant
• D. Allergy to aspirin

Correct answer: C

Rationale: The correct answer is C. It is crucial for the nurse to obtain information regarding the client's pregnancy status before administering misoprostol, as this medication is contraindicated in pregnancy due to its potential to cause uterine contractions. This can lead to serious complications such as miscarriage or premature birth. Therefore, assessing whether the client is currently pregnant is essential to ensure the safe administration of misoprostol. Choices A, B, and D are not directly related to the administration of misoprostol. While knowing if the client is taking an anti-emetic medication may be relevant to prevent drug interactions, a history of glaucoma and allergy to aspirin are not primary concerns before administering misoprostol.

3. A client who is recovering from an appendectomy is receiving narcotics. Earlier, the nurse witnessed the client's family pushing the pain pump. What should the nurse implement?

• A. Check the client's level of consciousness
• B. Instruct the family not to push the button
• C. Stop the client's basal infusion
• D. Administer a narcotic reversal medication

Correct answer: B

Rationale: Instructing the family not to push the button is necessary to prevent the client from receiving an excessive amount of narcotics, ensuring the safe and appropriate use of the pain pump. Checking the client's level of consciousness may not address the issue of family members pushing the button. Stopping the client's basal infusion is not indicated unless there are specific medical reasons for doing so. Administering a narcotic reversal medication is not necessary at this point as the issue lies with inappropriate use rather than an overdose.

4. A client with a diagnosis of schizophrenia is prescribed lurasidone. 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: The correct answer is A: Weight gain. When a client is prescribed lurasidone, monitoring for weight gain is essential as lurasidone can cause this side effect. Patients on lurasidone should have their weight monitored regularly to detect any changes that may occur. Options B, C, and D are not typically associated with lurasidone use, making them less likely to be a direct side effect of this medication.

5. A client with rheumatoid arthritis is prescribed sulfasalazine. Which instruction should the nurse include in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid sunlight while taking this medication.
• C. Report any signs of infection to the healthcare provider.
• D. Take this medication on an empty stomach.

Correct answer: A

Rationale: The correct instruction to include in the client's teaching plan regarding sulfasalazine is to take the medication with meals. Taking sulfasalazine with food helps to minimize gastrointestinal upset, which is a common side effect of the medication. Choice B is incorrect because avoiding sunlight is not specifically related to sulfasalazine. Choice C is important but not directly related to the administration of sulfasalazine. Choice D is incorrect because sulfasalazine should be taken with meals to reduce gastrointestinal side effects.

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