Nursing Elites

1. A client with a history of heart failure is prescribed carvedilol. The nurse should monitor the client for which adverse effect?

• A. Dizziness upon standing
• B. Weight loss
• C. Bradycardia
• D. Hypotension

Correct answer: D

Rationale: The correct answer is D: Hypotension. Carvedilol, a beta-blocker, can lead to hypotension by blocking the effects of adrenaline, which can cause blood vessels to dilate and reduce blood pressure. While dizziness upon standing is a potential adverse effect of carvedilol, it is more specifically related to orthostatic hypotension, which is a form of hypotension that occurs when a person stands up from a sitting or lying position. Weight loss and bradycardia are not typically associated with carvedilol use. Therefore, the nurse should primarily monitor for hypotension in a client taking carvedilol.

2. A client with hypertension is prescribed valsartan. The nurse should monitor the client for which potential side effect?

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

Correct answer: A

Rationale: The correct answer is A: Hypotension. Valsartan is an angiotensin II receptor blocker that can cause hypotension as a side effect by dilating blood vessels. Monitoring blood pressure is crucial to prevent complications related to low blood pressure. Choice B, Tachycardia, is incorrect because valsartan typically does not cause an increase in heart rate. Choice C, Hyperglycemia, is not a common side effect of valsartan. Choice D, Hyponatremia, is also unlikely with valsartan use.

3. A female client who started chemotherapy three days ago for cancer of the breast calls the clinic reporting that she is so upset she cannot sleep. The client has several PRN medications available. Which drug should the nurse instruct her to take?

• A. Ondansetron 8mgPO no
• B. Lorazepam 2mg PO bedtime
• C. Oxycodone, acetylsalicylic acid one tablet q4 hours PRN
• D. Acetaminophen, diphenhydramine 2 capsules bedtime

Correct answer: D

Rationale: Acetaminophen and diphenhydramine help with sleep without severe side effects.

4. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. The nurse should instruct the client to report which potential side effect?

• A. Dry mouth
• B. Blurred vision
• C. Nausea
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Dry mouth. Tiotropium, a commonly prescribed medication for COPD, can cause dry mouth as a side effect. While it may not be severe, clients should report it if it becomes bothersome. Dry mouth is a common side effect of tiotropium due to its anticholinergic properties. Blurred vision, nausea, and tachycardia are not typically associated with tiotropium use in the context of COPD.

5. A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?

• A. Take the medication at the same time every day.
• B. Discontinue the medication if a rash develops.
• C. Avoid consuming dairy products.
• D. Monitor blood pressure regularly.

Correct answer: A

Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin. Choices B, C, and D are incorrect because discontinuing the medication without healthcare provider guidance can be dangerous, there is no specific interaction between phenytoin and dairy products, and monitoring blood pressure is not a primary concern with phenytoin therapy for seizures.

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