Nursing Elites

1. When a patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium, the nurse should monitor for potential side effects. The correct answer is dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. This side effect can impact the patient's oral health and comfort, requiring close monitoring and appropriate interventions.

• A. Dry mouth
• B. Tachycardia
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: Ipratropium is an anticholinergic medication commonly used in COPD. One of the most common side effects of anticholinergics is dry mouth due to the inhibition of salivary gland function. Tachycardia (Choice B) is not a typical side effect of ipratropium. Insomnia (Choice C) is also not a common side effect of this medication. Increased appetite (Choice D) is not associated with ipratropium use. Therefore, the correct side effect to monitor for in a patient prescribed ipratropium is dry mouth.

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

• A. Agranulocytosis
• B. Hair loss
• C. Liver toxicity
• D. Weight gain

Correct answer: A

Rationale: Carbamazepine is associated with the potential adverse effect of agranulocytosis, a serious condition characterized by a low white blood cell count. Monitoring white blood cell counts regularly is crucial to detect this adverse effect early and prevent complications.

3. A client with chronic kidney disease is prescribed sevelamer carbonate. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed sevelamer carbonate, the nurse should monitor for hypercalcemia as a potential side effect. Sevelamer carbonate can bind to dietary calcium and impair its absorption, potentially leading to elevated calcium levels in the blood. Monitoring calcium levels is crucial to detect and manage hypercalcemia promptly. Hypocalcemia (choice B) is incorrect because sevelamer carbonate's action is more likely to cause elevated calcium levels. Hyperkalemia (choice C) and hypokalemia (choice D) are related to potassium levels and are not typically associated with sevelamer carbonate use.

4. 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.

5. A client with osteoporosis is prescribed raloxifene. The nurse should reinforce which instruction?

• A. Take this medication at the same time each day.
• B. Take this medication with a full glass of water.
• C. Take this medication on an empty stomach.
• D. Take this medication immediately after a meal.

Correct answer: A

Rationale: The correct instruction for a client prescribed raloxifene, a medication used for osteoporosis, is to take it at the same time each day. This consistency helps maintain steady blood levels of the medication, enhancing its effectiveness in managing the condition. Choice B is incorrect because raloxifene does not require a full glass of water for administration. Choice C is incorrect as raloxifene should not be taken on an empty stomach. Choice D is incorrect as raloxifene should not be taken immediately after a meal.

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