Nursing Elites

1. A client with a history of deep vein thrombosis is prescribed rivaroxaban. 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: When a client with a history of deep vein thrombosis is prescribed rivaroxaban, the nurse should monitor for signs of bleeding as rivaroxaban increases the risk of bleeding. Common adverse effects of rivaroxaban include bleeding events, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. It is crucial for the nurse to assess for these signs to prevent complications and ensure the client's safety. Choices B, C, and D are incorrect because rivaroxaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for bleeding is essential due to the anticoagulant properties of rivaroxaban.

2. A client is prescribed metoprolol. The nurse should monitor for which common side effect of this medication?

• A. Dizziness
• B. Fatigue
• C. Orthostatic hypotension
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Dizziness. Metoprolol, a beta-blocker, can lead to dizziness as a common side effect due to its mechanism of action in reducing heart rate and blood pressure. This effect can cause a sensation of lightheadedness or unsteadiness, particularly when standing up quickly. While fatigue, orthostatic hypotension, and headache are potential side effects of metoprolol, dizziness is commonly observed and should be closely monitored by the nurse to ensure patient safety.

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

• A. Weight gain
• B. Hair loss
• C. Insomnia
• D. Tremors

Correct answer: A

Rationale: When a client with bipolar disorder is prescribed quetiapine, the nurse should monitor for weight gain as a potential adverse effect. Quetiapine is known to commonly cause weight gain, which can have implications for the client's overall health. Regular monitoring of weight can help in early detection and management of this side effect.

4. A client with rheumatoid arthritis is prescribed adalimumab. What instruction should the nurse include in the client's teaching plan?

• A. Avoid live vaccines while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Report any signs of infection to the healthcare provider.
• D. Avoid sunlight exposure while taking this medication.

Correct answer: A

Rationale: The correct instruction for a client prescribed adalimumab, which is an immunosuppressant medication, is to avoid live vaccines. Adalimumab can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent complications and ensure the effectiveness of the treatment.

5. A client with asthma is prescribed fluticasone. The nurse should instruct the client to use this medication at which time?

• A. During an asthma attack
• B. Twice a day
• C. Once a day
• D. At night before bed

Correct answer: C

Rationale: Fluticasone is a maintenance medication for asthma aimed at controlling symptoms. It should be taken once a day on a regular basis to provide ongoing relief and prevent asthma symptoms, rather than being used to treat acute asthma attacks. Therefore, the correct answer is to use it once a day. Choices A, B, and D are incorrect because using fluticasone during an asthma attack, twice a day, or only at night before bed does not align with the medication's purpose of being a daily maintenance therapy.

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