Nursing Elites

1. A client with a history of deep vein thrombosis is prescribed apixaban. 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: The correct answer is A: Increased risk of bleeding. Apixaban is an anticoagulant medication that works by preventing blood clots. While this is beneficial for individuals with a history of deep vein thrombosis, it also increases the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. Monitoring for bleeding is crucial to ensure the client's safety and to take appropriate actions if necessary. Choices B, C, and D are incorrect because apixaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. The primary concern when administering apixaban is monitoring for potential bleeding complications.

2. A client is prescribed clonidine 0.1 mg/24 hours via a transdermal patch. Which client outcome would indicate that the medication is effective?

• A. No complaints of recent episodes of angina
• B. Change in peripheral edema from +3 to +1
• C. No complaints of new onset of nausea or vomiting
• D. Blood pressure changes from 180/120 to 140/70 mm Hg

Correct answer: D

Rationale: Clonidine is an antihypertensive agent that works centrally to reduce blood pressure. A significant decrease in blood pressure, such as changing from 180/120 to 140/70 mm Hg, indicates that the medication is effectively managing hypertension. Monitoring blood pressure levels is crucial in assessing the response to clonidine therapy. Choices A, B, and C are incorrect as they do not directly relate to the therapeutic effect of clonidine in managing hypertension, which is the primary goal of the medication in this scenario.

3. A client with a history of heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to an excess of potassium in the body, causing hyperkalemia. This medication inhibits the action of aldosterone, leading to decreased potassium excretion and potential retention. Monitoring potassium levels is essential to prevent complications such as cardiac arrhythmias, especially in clients with heart failure.

4. A client is prescribed amitriptyline for depression. The practical nurse (PN) should monitor for which potential side effect?

• A. Insomnia
• B. Weight loss
• C. Dry mouth
• D. Increased appetite

Correct answer: D

Rationale: The correct answer is 'D: Increased appetite.' Amitriptyline, a tricyclic antidepressant, is known to commonly cause increased appetite, leading to weight gain. Monitoring for increased appetite is crucial as it can impact the client's overall health and well-being. Choice A, 'Insomnia,' is less likely as amitriptyline is more associated with sedative effects. Choice B, 'Weight loss,' is incorrect as weight gain is a more common side effect. Choice C, 'Dry mouth,' is a potential side effect of amitriptyline, but it is not directly related to increased appetite, which is the primary concern in this case.

5. The healthcare provider is assessing the effectiveness of the drug amiodarone. Which client statement best indicates that the drug has been effective?

• A. I have not had as many spells of angina.
• B. I have not had as much swelling in my ankles lately.
• C. My doctor told me my cholesterol levels were improving with each visit.
• D. I do not notice as many irregular heartbeats as before I started taking this medication.

Correct answer: D

Rationale: The correct answer is option D. The effectiveness of amiodarone is best assessed by a reduction in irregular heartbeats since it is primarily used to treat ventricular dysrhythmias. This drug's main purpose is to control irregular heart rhythms, so a decrease in irregular heartbeats indicates its effectiveness. Options A, B, and C are incorrect because amiodarone is not primarily used to address angina, ankle swelling, or cholesterol levels, so improvements in these areas do not directly reflect the drug's effectiveness.

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