Nursing Elites

1. A client with a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: The correct answer is A: Bradycardia. Digoxin can lead to bradycardia due to its effect on slowing down the heart rate, which can be dangerous in a client with atrial fibrillation. Monitoring the client's heart rate is essential to detect and manage this potential side effect. Choices B, C, and D are incorrect because digoxin is not known to cause tachycardia, headache, or hyperglycemia as common side effects.

2. A client with a diagnosis of bipolar disorder is prescribed quetiapine. The nurse should monitor for which potential adverse effect?

• A. Weight gain
• B. Hair loss
• C. Insomnia
• D. Tremors

Correct answer: A

Rationale: When a client with bipolar disorder is prescribed quetiapine, the nurse should monitor for weight gain as a potential adverse effect. Quetiapine is known to commonly cause weight gain, which can have implications for the client's overall health. Regular monitoring of weight can help in early detection and management of this side effect.

3. A client with a history of deep vein thrombosis is prescribed enoxaparin. 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: Enoxaparin is an anticoagulant that works by preventing blood clots. One of the potential adverse effects of enoxaparin is an increased risk of bleeding due to its anticoagulant properties. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, petechiae, or blood in stool or urine, to ensure timely intervention and prevent complications.

4. A healthy 68-year-old client asks the practical nurse (PN) whether they should take the pneumococcal vaccine. Which statement should the PN offer to the client that provides the most accurate information about this vaccine?

• A. The vaccine is given annually before the flu season to those older than 50 years.
• B. The immunization is recommended for children younger than 2 years old and all adults 65 years or older.
• C. The vaccine is for all ages and is given primarily to those traveling overseas to areas of infection.
• D. The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years.

Correct answer: B

Rationale: The correct answer is B because it is usually recommended that children younger than 2 years old and adults 65 years or older get vaccinated against pneumococcal disease. This is because these age groups are more susceptible to severe complications from the infection. While the vaccine may be recommended for certain individuals with specific medical conditions at any age, the primary target groups are as mentioned in option B. Option A is incorrect as the pneumococcal vaccine is not given annually like the flu vaccine. Option C is incorrect because the vaccine is not primarily for travelers but for certain age groups and individuals with medical conditions at risk. Option D is incorrect as the vaccine's duration of protection can vary, and it is not guaranteed to prevent pneumococcal pneumonia for up to 5 years.

5. A client with diabetes mellitus type 2 is prescribed empagliflozin. The nurse should monitor for which potential adverse effect?

• A. Genital infections
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Genital infections. Empagliflozin, a medication commonly used to treat type 2 diabetes, is associated with an increased risk of genital infections. This is due to its mechanism of action, which involves promoting the excretion of glucose through urine, creating a more favorable environment for fungal or bacterial growth in the genital area. Choices B and C, hypoglycemia and hyperglycemia, are less likely adverse effects of empagliflozin. Empagliflozin actually carries a low risk of causing hypoglycemia since it works independently of insulin. Nausea (Choice D) is not a commonly reported adverse effect of empagliflozin, making it an incorrect choice in this scenario.

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