Nursing Elites

1. A client with a history of stroke is prescribed clopidogrel. The nurse should monitor the client for which potential side effect?

• A. Bleeding
• B. Bruising
• C. Nausea
• D. Headache

Correct answer: A

Rationale: Clopidogrel is an antiplatelet medication that works to prevent blood clots, but it can also increase the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, or unusual bleeding from the gums. Prompt identification and management of bleeding are crucial to prevent complications. Choices B, C, and D are incorrect because while bruising and other symptoms can occur as a result of bleeding, they are not the primary side effect to monitor for with clopidogrel. Nausea and headache are less commonly associated with clopidogrel use compared to bleeding.

2. A client is prescribed an antibiotic for a urinary tract infection (UTI). What instruction should the practical nurse provide to the client to ensure the effectiveness of the medication?

• A. Take the medication with food.
• B. Increase fluid intake.
• C. Complete the full course of the medication.
• D. Avoid dairy products.

Correct answer: C

Rationale: The practical nurse should instruct the client to complete the full course of the antibiotic to ensure the infection is fully treated and to prevent the development of antibiotic resistance. Completing the full course of antibiotics helps to eradicate the infection completely and reduces the risk of bacteria developing resistance to the medication. Choices A, B, and D are not directly related to ensuring the effectiveness of the antibiotic. While taking medication with food or increasing fluid intake can be beneficial in general, the crucial instruction in this case is to complete the full course of the antibiotic.

3. The practical nurse is assigned a client on digoxin therapy. Which finding is likely to predispose this client to developing digoxin toxicity?

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

Correct answer: D

Rationale: Hypokalemia predisposes a client on digoxin to digoxin toxicity. Symptoms of digoxin toxicity include abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and atrioventricular (AV) dissociation. Therefore, assessment of serum potassium levels and prompt correction of hypokalemia are crucial interventions for clients taking digoxin.

4. A practical nurse (PN) is providing education to a client who is starting therapy with metformin for type 2 diabetes. What side effect should the client be instructed to report to the healthcare provider?

• A. Weight gain
• B. Hypoglycemia
• C. Muscle pain
• D. Nausea

Correct answer: D

Rationale: The correct answer is 'Nausea.' Nausea is a common side effect of metformin, especially when the medication is first started. It is essential for the client to report persistent or severe nausea to the healthcare provider for further evaluation and management. Weight gain (Choice A) is not a typical side effect of metformin; in fact, metformin is associated with weight loss or weight neutrality. Hypoglycemia (Choice B) is a potential side effect of some diabetes medications, but metformin does not typically cause hypoglycemia. Muscle pain (Choice C) is not a common side effect of metformin; it is more commonly associated with other medications like statins.

5. 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.

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