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. Escitalopram is prescribed for a 16-year-old adolescent client who is clinically depressed. Five days later, the parent tells the practical nurse (PN) that the drug is not working because their child is not feeling any better. Which explanation should the PN provide?

• A. It takes 1 to 4 weeks for antidepressant medications to become effective.
• B. The dosage may need to be increased; I will contact your health care provider.
• C. Depression is difficult to treat with drugs alone. Therapy sessions would enhance their effectiveness.
• D. Based on your child's response to this drug, the health care provider is reviewing your medication regimen.

Correct answer: A

Rationale: Antidepressant medications typically require 1 to 4 weeks to reach their full therapeutic effect. It is crucial to educate the family that during the initial week of treatment, the child may experience heightened anxiety. Therefore, it is important to wait for the medication to take its full course before assessing its effectiveness.

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

• A. Weight gain
• B. Dry mouth
• C. Dizziness
• D. Headache

Correct answer: A

Rationale: The correct answer is weight gain. Rivaroxaban, an anticoagulant, may lead to weight gain as a side effect due to fluid retention. Dry mouth (choice B), dizziness (choice C), and headache (choice D) are not typically associated with rivaroxaban use. Therefore, monitoring for weight gain is crucial to detect and manage this potential side effect in the client.

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

• A. Administer this medication once a week.
• B. Administer this medication once a month.
• C. Administer this medication twice a day.
• D. Administer this medication once a day.

Correct answer: D

Rationale: The correct answer is to administer liraglutide once a day. Liraglutide is typically prescribed to be taken once daily, as directed by the healthcare provider. This dosing schedule helps maintain consistent levels of the medication in the body to effectively manage blood sugar levels in clients with diabetes mellitus type 2. Option A, administering once a week, is incorrect as it would not provide consistent control of blood sugar levels. Option B, administering once a month, is also incorrect as it is not the recommended dosing frequency for liraglutide. Option C, administering twice a day, is inaccurate as liraglutide is not typically dosed in this manner. It is important for the nurse to emphasize the importance of adherence to the prescribed dosing regimen to achieve optimal therapeutic outcomes.

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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