Nursing Elites

1. 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.

2. When a client with a history of deep vein thrombosis is prescribed fondaparinux, the nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: Fondaparinux is an anticoagulant prescribed to prevent blood clots. Therefore, the nurse should monitor the client for an increased risk of bleeding, which is a potential adverse effect of this medication. Choices B, C, and D are incorrect because fondaparinux does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for signs of bleeding, such as unexplained bruising, bleeding gums, or blood in the urine or stool, is crucial when a client is on fondaparinux.

3. A practical nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving theophylline. Which symptom indicates that the client may be experiencing theophylline toxicity?

• A. Bradycardia
• B. Tremors
• C. Constipation
• D. Hypotension

Correct answer: B

Rationale: Tremors are a common symptom of theophylline toxicity. Other symptoms that may indicate theophylline toxicity include nausea, vomiting, and seizures. Bradycardia, constipation, and hypotension are not typically associated with theophylline toxicity. It is important for the nurse to monitor the client closely for these signs of toxicity and report them promptly to the healthcare provider to prevent further complications.

4. A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse (PN) reinforce to this client?

• A. Maintain consistent sodium intake.
• B. Use sunscreen when outdoors.
• C. Return for monthly urinalysis.
• D. Brush and floss teeth daily.

Correct answer: D

Rationale: The correct answer is to reinforce the instruction to brush and floss teeth daily. Phenytoin therapy can lead to gingival hyperplasia (gum disease), which can be prevented by maintaining good oral hygiene practices such as brushing and flossing daily. Choices A, B, and C are incorrect because they are not directly related to the side effects or management of phenytoin therapy. Maintaining consistent sodium intake is not a specific concern with phenytoin. Using sunscreen when outdoors is important to prevent sunburn but is not directly related to phenytoin therapy. Returning for monthly urinalysis may be necessary for other medications, but it is not specifically required for monitoring phenytoin therapy.

5. After receiving the third dose of a new oral anticoagulant prescription, which action should the nurse implement? Select all that apply.

• A. Notify the healthcare provider of the finding
• B. Provide a PRN NSAID for gum discomfort
• C. Review the most recent coagulation lab values
• D. Complete a medication variance report

Correct answer: C

Rationale: Reviewing the most recent coagulation lab values is crucial after receiving multiple doses of a new oral anticoagulant to ensure the patient is within the desired therapeutic range and to prevent adverse events related to over or under-anticoagulation. It is essential to monitor these values closely to adjust the dosage if needed. Notifying the healthcare provider of any concerning findings is important, but it may not be the immediate priority after receiving the third dose. Providing a PRN NSAID for gum discomfort is not typically indicated with oral anticoagulant therapy, as it may increase the risk of bleeding. Completing a medication variance report is more relevant in cases of medication errors or discrepancies, which may not apply in this scenario.

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