Nursing Elites

1. A client with a diagnosis of schizophrenia is prescribed quetiapine. 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: Quetiapine is known to cause weight gain as a common side effect. Monitoring the client's weight is crucial to identify any significant changes that may occur due to the medication.

2. A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines the client has been self-administering St. John's wort, an herbal preparation, on the advice of a friend. What information is most significant about this finding?

• A. Wort can decrease plasma concentration of Cyclospora
• B. Wort can decrease plasma concentration of Tacrolimus
• C. Wort can decrease plasma concentration of Cyclosporine
• D. Wort can decrease plasma concentration of Mycophenolate

Correct answer: C

Rationale: The most significant information about the client self-administering St. John's wort, an herbal preparation, is that it can decrease the plasma concentration of Cyclosporine. St. John's wort is known to reduce the efficacy of Cyclosporine, which is a common immunosuppressant drug used to prevent transplant rejection. Choices A, B, and D are incorrect because St. John's wort does not affect the plasma concentration of Cyclospora, Tacrolimus, or Mycophenolate.

3. A client with a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which sign of digoxin toxicity?

• A. Bradycardia
• B. Tachycardia
• C. Nausea
• D. Vomiting

Correct answer: A

Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a medication used to treat atrial fibrillation, can lead to toxicity manifesting as various cardiac dysrhythmias, with bradycardia being a notable indicator. Monitoring for bradycardia is crucial as it can indicate the need for dosage adjustment or discontinuation of digoxin to prevent adverse effects. Tachycardia, nausea, and vomiting are not typically associated with digoxin toxicity, making them incorrect choices for monitoring in a client receiving this medication.

4. What action should the nurse implement for a female client taking the bisphosphonate medication ibandronate for osteoporosis?

• A. Ask the client to describe how she takes the medication
• B. Reassure the client that the heartburn is temporary
• C. Explain that the use of antacids might be helpful
• D. Encourage the client to increase her calcium intake

Correct answer: A

Rationale: Ensuring correct administration of bisphosphonates, like ibandronate, is essential to maximize effectiveness and minimize potential side effects. By asking the client to describe how she takes the medication, the nurse can assess the client's understanding and adherence to the prescribed regimen, ultimately promoting optimal therapeutic outcomes.

5. How do you determine if the medication is effective for a client with anemia secondary to chronic kidney disease (CKD)?

• A. Food diary shows increased consumption of iron-rich foods
• B. Reports of increased energy levels and decreased fatigue
• C. Hemoglobin level increased to 12 grams/dL
• D. Takes concurrent iron therapy without adverse effects

Correct answer: C

Rationale: The correct answer is C. To assess the effectiveness of medication for anemia in a client with CKD, monitoring hemoglobin levels is crucial. Hemoglobin levels directly indicate the response to treatment and improvement in the condition. An increase in hemoglobin level to 12 grams/dL suggests that the medication is effectively addressing the anemia associated with CKD. Choices A, B, and D are incorrect because increased consumption of iron-rich foods, reports of increased energy levels and decreased fatigue, and tolerance to concurrent iron therapy without adverse effects are not direct indicators of the medication's effectiveness in treating anemia secondary to CKD.

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