Nursing Elites

1. When a client with a history of deep vein thrombosis is prescribed fondaparinux, 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: Fondaparinux is an anticoagulant prescribed to prevent blood clots. Therefore, the nurse should monitor the client for an increased risk of bleeding, which is a potential adverse effect of this medication. Choices B, C, and D are incorrect because fondaparinux does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for signs of bleeding, such as unexplained bruising, bleeding gums, or blood in the urine or stool, is crucial when a client is on fondaparinux.

2. A client with an exacerbation of asthma is prescribed albuterol. The nurse should assess the client for which common side effect of this medication?

• A. Tremors
• B. Nausea and vomiting
• C. Insomnia
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Tremors. Albuterol, a beta-agonist medication commonly used to treat asthma exacerbations, can lead to tremors as a side effect. Tremors result from the stimulation of beta-2 receptors in muscles, particularly in the hands. Nausea and vomiting (Choice B) are generally not common side effects of albuterol. Insomnia (Choice C) is less likely to occur with albuterol, as it is a stimulant and can cause alertness rather than sleep disturbances. Dry mouth (Choice D) is not a typical side effect associated with albuterol use.

3. A client is receiving metronidazole for Clostridium difficile pseudomembranous colitis. Which information should the nurse include in this client's medication teaching plan?

• A. Drink adequate water daily
• B. Take with food
• C. Avoid alcohol consumption
• D. Store medication in the refrigerator

Correct answer: C

Rationale: The correct information to include in the medication teaching plan for a client receiving metronidazole for Clostridium difficile pseudomembranous colitis is to avoid alcohol consumption. Metronidazole can cause a disulfiram-like reaction when combined with alcohol, leading to symptoms such as nausea, vomiting, flushing, and headache. Therefore, it is crucial for the client to abstain from alcohol while taking this medication to prevent adverse effects and ensure treatment effectiveness. Choices A, B, and D are incorrect. Drinking adequate water daily is a general health recommendation but not specific to metronidazole use. Taking with food is not necessary for metronidazole, and in fact, it is recommended to be taken on an empty stomach for better absorption. Storing the medication in the refrigerator is also incorrect, as metronidazole should be stored at room temperature.

4. A client with a history of chronic kidney disease is prescribed epoetin alfa. The nurse should monitor for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Hyperglycemia
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Epoetin alfa can lead to hypertension as an adverse effect because it stimulates increased red blood cell production. This can result in elevated blood pressure levels, requiring careful monitoring by the nurse to prevent complications. Choice B, hypotension, is incorrect because epoetin alfa is more likely to cause hypertension rather than hypotension. Choice C, hyperglycemia, and Choice D, tachycardia, are also incorrect as they are not commonly associated with the use of epoetin alfa.

5. A client arrives at the emergency department experiencing diabetic ketoacidosis (DKA). The healthcare provider prescribes an insulin intravenous drip. Which type of insulin should the nurse locate for the registered nurse to mix into the intravenous fluids?

• A. Isophane
• B. Glargine
• C. Regular
• D. Detemir

Correct answer: C

Rationale: The correct insulin type for the nurse to mix into the intravenous fluids is regular insulin. In the scenario of diabetic ketoacidosis (DKA), rapid reduction of blood glucose levels is crucial. Regular insulin has a fast onset of action, making it suitable for intravenous administration to address the high blood sugar levels seen in DKA. Isophane, Glargine, and Detemir are not appropriate choices for intravenous administration in this emergency situation as they are intermediate-acting or long-acting insulins which do not provide the rapid response needed in DKA.

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