Nursing Elites

1. A client with a diagnosis of generalized anxiety disorder is prescribed paroxetine. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Paroxetine, used for generalized anxiety disorder, can cause drowsiness. Clients should be advised not to drive or operate heavy machinery until they know how the medication affects them. Dry mouth, nausea, and headache are potential side effects of other medications but are not commonly associated with paroxetine. Drowsiness is a common side effect for paroxetine and can impact a client's ability to perform tasks that require alertness.

2. 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.

3. A client with hypertension is prescribed hydrochlorothiazide. The nurse should monitor the client for which potential side effect?

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

Correct answer: B

Rationale: When a client is prescribed hydrochlorothiazide, the nurse should monitor for hypokalemia as a potential side effect. Hydrochlorothiazide is a diuretic that can lead to potassium loss, hence monitoring potassium levels is crucial to prevent complications related to hypokalemia.

4. A client with pulmonary tuberculosis has been taking rifampin for 3 weeks. The client reports orange urine. What should be the nurse's next action?

• A. Notify the client's health care provider.
• B. Inform the client that this is not harmful.
• C. Assess the client for other signs of nephrotoxicity.
• D. Monitor the client's most recent creatinine level.

Correct answer: B

Rationale: The correct action for the nurse to take when a client reports orange urine after taking rifampin is to inform the client that this change is not harmful. Rifampin is known to cause orange discoloration of urine, which is a harmless side effect. There is no need to notify the health care provider as this is an expected outcome. Monitoring creatinine levels or assessing for nephrotoxicity is unnecessary in this situation, as rifampin does not typically cause kidney damage.

5. A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?

• A. The client is experiencing vision and hearing loss.
• B. The client has an erection lasting longer than 4 hours.
• C. The client is complaining of nasal congestion.
• D. The client is complaining of feeling flushed.

Correct answer: A

Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications. Choices B, C, and D are incorrect because an erection lasting more than 2 hours (not 4 hours as stated in choice B) is a critical adverse effect that warrants immediate medical attention. Nasal congestion (choice C) and feeling flushed (choice D) are common side effects of sildenafil and typically do not necessitate immediate discontinuation of the medication or emergency intervention.

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