Nursing Elites

1. A client with a history of deep vein thrombosis is prescribed warfarin. 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. Warfarin is an anticoagulant medication that works by prolonging the time it takes for blood to clot. Therefore, a potential adverse effect of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, nosebleeds, or blood in the urine or stool. Monitoring for these signs is essential to prevent serious complications associated with excessive bleeding. Choices B, C, and D are incorrect because warfarin does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. The primary concern with warfarin therapy is the potential for bleeding complications, so close monitoring for signs of bleeding is essential.

2. A client with diabetes mellitus type 2 is prescribed linagliptin. The nurse should monitor for which potential adverse effect?

• A. Pancreatitis
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: When a client with diabetes mellitus type 2 is prescribed linagliptin, the nurse should monitor for pancreatitis as a potential adverse effect. Linagliptin has been associated with rare cases of pancreatitis; therefore, monitoring for signs and symptoms of pancreatitis such as severe abdominal pain, nausea, and vomiting is crucial to ensure timely intervention and management.

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

• A. Agranulocytosis
• B. Hair loss
• C. Liver toxicity
• D. Weight gain

Correct answer: A

Rationale: Carbamazepine is associated with the potential adverse effect of agranulocytosis, a serious condition characterized by a low white blood cell count. Monitoring white blood cell counts regularly is crucial to detect this adverse effect early and prevent complications.

4. A client with hypertension is prescribed lisinopril. The nurse should monitor for which potential side effect?

• A. Dry cough
• B. Hyperkalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Dry cough. Lisinopril, an ACE inhibitor, is known to cause a persistent dry cough as a common side effect. Monitoring for this adverse effect is crucial because it may lead to non-adherence to the medication. Hyperkalemia (choice B) is a potential side effect of potassium-sparing diuretics, not ACE inhibitors like lisinopril. Hypernatremia (choice C) refers to elevated sodium levels and is not a common side effect of lisinopril. Hyponatremia (choice D) is a condition characterized by low sodium levels and is not a typical side effect of lisinopril. Therefore, the nurse should focus on assessing the client for a dry cough when taking lisinopril.

5. A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

• A. Avoid hazardous activities until symptoms subside
• B. Contact the healthcare provider immediately
• C. Continue taking the medication every day
• D. Stop taking the medication until the unpleasant side effects wear off

Correct answer: A

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid hazardous activities until the symptoms of fatigue and dizziness subside. These side effects can impair the client's ability to engage in activities that require alertness and coordination, posing a risk for accidents. Contacting the healthcare provider immediately may not be necessary unless the symptoms worsen or persist. Continuing to take the medication every day without addressing the side effects can lead to further complications. Stopping the medication abruptly without healthcare provider guidance can also be risky and may not be necessary if the symptoms improve with time.

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