Nursing Elites

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

• A. Agranulocytosis
• B. Dry mouth
• C. Weight gain
• D. Hypersalivation

Correct answer: A

Rationale: The correct answer is Agranulocytosis. Clozapine is known to potentially cause agranulocytosis, a serious condition characterized by a dangerously low white blood cell count. Monitoring white blood cell counts is crucial to detect this side effect early and prevent complications. Choices B, C, and D are incorrect because dry mouth, weight gain, and hypersalivation are not typically associated with clozapine use. While dry mouth can be a common side effect of some antipsychotic medications, it is not specifically linked to clozapine. Weight gain can occur with certain antipsychotics, but clozapine is more commonly associated with metabolic side effects. Hypersalivation is not a common side effect of clozapine.

2. A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?

• A. Increased risk of infection
• B. Bone marrow suppression
• C. Hair loss
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.

3. 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.

4. A client is admitted to a long-term care facility, and the nurse and a new employee are conducting medication reconciliation. The nurse notes that oxybutynin has been prescribed. The nurse realizes the new employee understands the drug's effect if the new employee explains that this medication is prescribed to treat which condition?

• A. Pain
• B. Depression
• C. Overactive bladder
• D. Chronic anxiety

Correct answer: C

Rationale: The correct answer is C: Overactive bladder. Oxybutynin is prescribed to treat overactive bladder by reducing muscle spasms of the bladder. It is classified as an anticholinergic medication. Choices A, B, and D are incorrect. Oxycodone is an opioid used for pain management. Bupropion is an antidepressant used to treat depression. Buspirone is an anxiolytic used to manage anxiety disorders.

5. A client is prescribed amitriptyline for depression. The practical nurse (PN) should monitor for which potential side effect?

• A. Insomnia
• B. Weight loss
• C. Dry mouth
• D. Increased appetite

Correct answer: D

Rationale: The correct answer is 'D: Increased appetite.' Amitriptyline, a tricyclic antidepressant, is known to commonly cause increased appetite, leading to weight gain. Monitoring for increased appetite is crucial as it can impact the client's overall health and well-being. Choice A, 'Insomnia,' is less likely as amitriptyline is more associated with sedative effects. Choice B, 'Weight loss,' is incorrect as weight gain is a more common side effect. Choice C, 'Dry mouth,' is a potential side effect of amitriptyline, but it is not directly related to increased appetite, which is the primary concern in this case.

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