Nursing Elites

1. A client with a diagnosis of depression is prescribed escitalopram. Which statement by the client indicates the need for further teaching?

• A. I should take this medication in the morning with food.
• B. This medication may take 1 to 4 weeks to notice improvement in symptoms.
• C. I can stop taking this medication once I feel better.
• D. This medication might make me feel drowsy.

Correct answer: C

Rationale: It is crucial for clients to understand that they should not discontinue escitalopram abruptly, even if they start feeling better. Stopping the medication suddenly can lead to withdrawal symptoms or a relapse of depression. It is essential to complete the full course of treatment as prescribed by the healthcare provider to ensure the best outcomes and prevent potential complications.

2. A client with diabetes mellitus type 2 is prescribed saxagliptin. The nurse should include which instruction in the client's teaching plan?

• A. Report any signs of pancreatitis to the healthcare provider.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of heart failure to the healthcare provider.

Correct answer: A

Rationale: Corrected Rationale: When a client with diabetes mellitus type 2 is prescribed saxagliptin, it is crucial to instruct them to report any signs of pancreatitis to the healthcare provider. Saxagliptin can lead to pancreatitis as a side effect, making it essential for clients to be vigilant about recognizing and reporting any related symptoms promptly for timely intervention and management. Choice B is incorrect because saxagliptin can be taken with or without meals. Choice C is not specifically associated with saxagliptin use. Choice D is incorrect as heart failure is not a common side effect of saxagliptin.

3. 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.

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

• A. QT prolongation
• B. Weight gain
• C. Dry mouth
• D. Increased appetite

Correct answer: A

Rationale: The correct answer is A: QT prolongation. Ziprasidone is known to cause QT prolongation, which can potentially lead to serious cardiac issues. Monitoring the client's ECG is crucial to detect any changes and prevent adverse effects related to QT interval prolongation. Choices B, C, and D are incorrect because weight gain, dry mouth, and increased appetite are not commonly associated with ziprasidone. While weight gain can be a side effect of some antipsychotic medications, it is not a prominent side effect of ziprasidone. Dry mouth and increased appetite are also not typically linked to ziprasidone use.

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

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

Correct answer: D

Rationale: Hydroxychloroquine is known to cause vision changes, including retinopathy. Therefore, it is crucial for clients to report any vision changes promptly to their healthcare provider to prevent any potential ocular complications. While sunlight exposure should be limited due to photosensitivity, the key concern with hydroxychloroquine is the risk of vision changes, not gastrointestinal upset or infections.

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