Nursing Elites

1. How do you determine if the medication is effective for a client with anemia secondary to chronic kidney disease (CKD)?

• A. Food diary shows increased consumption of iron-rich foods
• B. Reports of increased energy levels and decreased fatigue
• C. Hemoglobin level increased to 12 grams/dL
• D. Takes concurrent iron therapy without adverse effects

Correct answer: C

Rationale: The correct answer is C. To assess the effectiveness of medication for anemia in a client with CKD, monitoring hemoglobin levels is crucial. Hemoglobin levels directly indicate the response to treatment and improvement in the condition. An increase in hemoglobin level to 12 grams/dL suggests that the medication is effectively addressing the anemia associated with CKD. Choices A, B, and D are incorrect because increased consumption of iron-rich foods, reports of increased energy levels and decreased fatigue, and tolerance to concurrent iron therapy without adverse effects are not direct indicators of the medication's effectiveness in treating anemia secondary to CKD.

2. A client with a diagnosis of schizophrenia is prescribed olanzapine. The nurse should monitor the client for which potential side effect?

• A. Weight gain
• B. Dry mouth
• C. Hair loss
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Weight gain. Olanzapine is known to cause weight gain as a common side effect. This weight gain can increase the risk of metabolic issues such as diabetes and dyslipidemia. Monitoring the client's weight regularly is essential to detect and address any weight changes promptly.

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

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Bleeding. Warfarin is an anticoagulant medication that works by thinning the blood. One of the potential side effects of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as unusual bruising, blood in the urine or stool, or prolonged bleeding from cuts or gums. Prompt recognition and management of bleeding are essential to prevent complications. Choices B, C, and D are incorrect as weight gain, headache, and dizziness are not common side effects of warfarin. Monitoring for bleeding is a priority due to the anticoagulant properties of warfarin.

4. A client with a productive cough and fever has been diagnosed with bacterial pneumonia and is being admitted to the unit from the emergency room. Which intervention should the practical nurse ensure has been done prior to the administration of antibiotics?

• A. Sputum specimen
• B. Set of vital signs
• C. Electrocardiogram
• D. Glucometer check

Correct answer: A

Rationale: Before initiating antibiotic therapy in a client with bacterial pneumonia, obtaining a sputum specimen for culture and sensitivity is essential. This helps identify the specific bacteria causing the infection and guides the selection of the most effective antibiotic treatment.

5. Twenty-four hours after starting to take oral penicillin for strep throat, a client calls the nurse to report the onset of a rash on the chest. What action should the nurse implement?

• A. Instruct the client to discontinue the penicillin immediately
• B. Instruct the client regarding the use of topical analgesic cream PRN
• C. Question the client about any other related symptoms
• D. Reinforce the need to take all doses of the penicillin

Correct answer: A

Rationale: In this scenario, the client has developed a rash after starting oral penicillin, which can indicate an allergic reaction. It is crucial for the nurse to instruct the client to discontinue the penicillin immediately. Continuing the medication can potentially lead to severe allergic reactions. Instructing about topical analgesic cream or questioning about other related symptoms may delay appropriate action in case of a severe allergic reaction. Reinforcing the need to complete all doses is not appropriate when an allergic reaction is suspected, as safety takes precedence over completing the antibiotic course.

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