Nursing Elites

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

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

Correct answer: A

Rationale: Corrected Rationale: Sotalol, a medication used for atrial fibrillation, is known to cause bradycardia, which is a slower than normal heart rate. Monitoring the client's heart rate is essential to detect and manage this potential side effect promptly. Choice B, Tachycardia, is incorrect as sotalol is more likely to cause bradycardia. Choice C, Headache, and Choice D, Hyperglycemia, are unrelated side effects of sotalol and are not commonly associated with this medication.

2. A client with a history of hypertension is prescribed amlodipine. The nurse should monitor the client for which potential adverse effect?

• A. Peripheral edema
• B. Tachycardia
• C. Bradycardia
• D. Increased appetite

Correct answer: A

Rationale: Corrected Rationale: Amlodipine is a calcium channel blocker commonly associated with causing peripheral edema as an adverse effect. The nurse should monitor the client for signs of swelling, particularly in the lower extremities, as it may indicate a need for dosage adjustment or further evaluation. Choices B, C, and D are incorrect as amlodipine is not known to cause tachycardia, bradycardia, or increased appetite as adverse effects.

3. A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should include which instruction in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid alcohol while taking this medication.
• C. Take this medication on an empty stomach.
• D. Report any signs of pancreatitis to the healthcare provider.

Correct answer: D

Rationale: The correct instruction to include in the teaching plan for a client prescribed sitagliptin is to report any signs of pancreatitis to the healthcare provider. Sitagliptin is generally taken with meals to reduce gastrointestinal side effects. Therefore, choice A, 'Take this medication with meals,' is incorrect. Sitagliptin does not have specific interactions with alcohol, so there is no need to advise the client to avoid alcohol, making choice B incorrect. Taking sitagliptin on an empty stomach is not recommended, so choice C is also incorrect. Pancreatitis is a rare but serious side effect of sitagliptin, so it is crucial for the client to report any signs or symptoms to their healthcare provider promptly.

4. A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?

• A. Dilute the available heparin in 250ml of normal saline solution prior to IV administration
• B. Advise the pharmacy on the need to deliver a vial of heparin to the nursing unit immediately
• C. Calculate and administer the equivalent dose of the available low molecular weight heparin
• D. Request a prescription to change the route of administration and use the available heparin

Correct answer: B

Rationale: In this scenario, the nurse should contact the pharmacy to obtain the correct heparin formulation as the prescription calls for heparin 1,000 units IV STAT. Low molecular weight heparin is not the same as unfractionated heparin, and therefore, the nurse should not administer the available low molecular weight heparin without first obtaining the correct medication. Diluting the available heparin, calculating an equivalent dose, or changing the route of administration would not address the discrepancy between the prescribed heparin and the available low molecular weight heparin.

5. A client with diabetes mellitus type 2 is prescribed pioglitazone. What instruction should the nurse include in the client's teaching plan?

• A. Report any signs of heart failure.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of bladder cancer.

Correct answer: A

Rationale: The correct answer is to instruct the client to report any signs of heart failure when taking pioglitazone. Pioglitazone is known to potentially exacerbate heart failure, so it is crucial for clients to monitor and report any symptoms of heart failure promptly to their healthcare provider for appropriate management. Choices B and C are important but not specific to pioglitazone use. Choice D is incorrect as bladder cancer is not a known side effect of pioglitazone.

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