Nursing Elites

1. A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed salmeterol. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: The correct answer is dry mouth. Salmeterol, a long-acting beta agonist used in COPD, can lead to dry mouth as a common side effect. Nurses should monitor for this side effect and advise clients to report it if it becomes bothersome.

2. When educating a client about the adverse effects of conjunctivitis, what is a serious condition that requires prompt attention?

• A. Contact lens irritation
• B. Decreased sex drive
• C. Brown spots on the skin
• D. Epigastric pain unrelieved by antacids

Correct answer: D

Rationale: Epigastric pain unrelieved by antacids is a concerning symptom that may indicate a more serious underlying condition such as a perforated ulcer. This symptom requires immediate medical attention to prevent further complications.

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. 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.

5. Prior to administering an oral dose of methylprednisolone, what is most important for the nurse to do?

• A. Administer the medication with a glass of milk
• B. Notify the healthcare provider of the finding
• C. Begin tapering the drug dose per protocol
• D. Teach the clients about foods high in calcium

Correct answer: A

Rationale: Administering methylprednisolone with food or milk is important as it can help reduce gastrointestinal side effects associated with the medication. This practice is commonly recommended to minimize stomach upset and irritation that may occur when taking methylprednisolone on an empty stomach. Therefore, it is crucial for the nurse to provide the medication with a glass of milk to enhance patient comfort and adherence to the treatment regimen. Choice B is incorrect as there is no indication in the question stem that suggests a need to notify the healthcare provider before administering the medication with food or milk. Choice C is incorrect because tapering the drug dose per protocol is not the immediate action needed prior to administering the first dose of methylprednisolone. Choice D is irrelevant to the administration of methylprednisolone and not the most important action to take before giving the medication.

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