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 diagnosed with angina has been prescribed nitrate isosorbide dinitrate. Which instruction should the practical nurse reinforce in this client's teaching?

• A. Discontinue the medication if dizziness occurs.
• B. Avoid getting up quickly. Always rise slowly.
• C. Take the medication with or without food.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction that the practical nurse should reinforce with a client prescribed nitrate isosorbide dinitrate is to avoid getting up quickly and to rise slowly. Nitrates can cause orthostatic hypotension, a sudden drop in blood pressure when changing positions. By rising slowly, the client can prevent the occurrence of orthostatic hypotension and its associated symptoms. Choices A, C, and D are incorrect because discontinuing the medication without consulting a healthcare provider can be dangerous, taking the medication with or without food does not impact its effectiveness, and increasing potassium intake is not directly related to the use of nitrate isosorbide dinitrate.

3. A 67-year-old client is discharged from the hospital with a prescription for digoxin 0.25 mg daily. Which instruction by the practical nurse (PN) is correct?

• A. Take the medication in the morning before getting out of bed.
• B. Do not take the medication if the heartbeat is irregular or slow.
• C. Expect some vision changes due to the medication.
• D. Increase intake of foods rich in potassium.

Correct answer: B

Rationale: The correct instruction for a client taking digoxin is not to take the medication if the heartbeat is irregular or slow. Digoxin can affect the heart rhythm, so it is crucial to monitor the pulse rate. In case of irregular or slow heartbeats, the medication should be withheld, and the healthcare provider should be consulted. This step is necessary to prevent potential complications associated with digoxin therapy. Choices A, C, and D are incorrect. Taking digoxin in the morning before getting out of bed is not a specific requirement. Vision changes are not a common side effect of digoxin. While digoxin can affect potassium levels, it is not advised to increase potassium intake without healthcare provider guidance.

4. A client with hypertension is prescribed clonidine. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Dizziness
• D. Hyperglycemia

Correct answer: A

Rationale: When a client is prescribed clonidine, the nurse should monitor for bradycardia as a potential side effect. Clonidine can lead to a decrease in heart rate, thus causing bradycardia. Monitoring the client's heart rate is crucial to detect and manage this adverse effect.

5. A client with a history of chronic kidney disease is prescribed epoetin alfa. The nurse should monitor for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Hyperglycemia
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Epoetin alfa can lead to hypertension as an adverse effect because it stimulates increased red blood cell production. This can result in elevated blood pressure levels, requiring careful monitoring by the nurse to prevent complications. Choice B, hypotension, is incorrect because epoetin alfa is more likely to cause hypertension rather than hypotension. Choice C, hyperglycemia, and Choice D, tachycardia, are also incorrect as they are not commonly associated with the use of epoetin alfa.

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