Nursing Elites

1. A client with asthma is receiving long-term glucocorticoid therapy. The nurse includes a risk for impaired skin integrity on the client's problem list. What is the rationale for including this problem?

• A. Abnormal fat deposits impair circulation
• B. Frequent diarrhea can lead to skin issues
• C. Thinned skin bruises easily
• D. Decreased serum glucose prolongs healing time

Correct answer: C

Rationale: The correct answer is C. Glucocorticoids can cause skin thinning, which increases the likelihood of bruising. Thinning of the skin due to glucocorticoid therapy makes it more fragile and prone to injury, such as bruising, even with minimal trauma. Choices A, B, and D are incorrect because abnormal fat deposits impairing circulation, frequent diarrhea causing skin issues, and decreased serum glucose prolonging healing time are not direct effects of glucocorticoid therapy on skin integrity.

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. The healthcare provider has administered albuterol as an inhaled medication. The healthcare provider should monitor the client for which possible adverse reaction?

• A. Enuresis
• B. Lethargy
• C. Depression
• D. Tachycardia

Correct answer: D

Rationale: Albuterol is a bronchodilator in the adrenergic category. Its actions and adverse effects are similar to adrenaline or epinephrine. The healthcare provider should monitor the client for tachycardia, which is a common adverse effect of albuterol due to its stimulant effect on beta-2 receptors. Enuresis, or night bed-wetting, is not an adverse effect associated with albuterol. Additionally, the client should be monitored for anxiety as a potential adverse effect, not lethargy or depression, which are not typically associated with albuterol administration.

4. A practical nurse is reviewing the medication administration record for a client prescribed prednisone. What potential side effect should the nurse monitor for?

• A. Hypoglycemia
• B. Weight loss
• C. Hypertension
• D. Diarrhea

Correct answer: C

Rationale: Prednisone, a corticosteroid, can cause side effects such as hypertension, fluid retention, and weight gain. Hypertension is a common side effect of prednisone due to its impact on sodium and fluid retention in the body. Monitoring blood pressure is crucial to detect and manage hypertension in clients taking prednisone. Choices A, B, and D are incorrect. While prednisone can indirectly affect blood glucose levels, hypoglycemia is not a common side effect. Weight gain, not weight loss, is more prevalent with prednisone use. Diarrhea is not a typical side effect associated with prednisone.

5. A client is admitted to a long-term care facility, and the nurse and a new employee are conducting medication reconciliation. The nurse notes that oxybutynin has been prescribed. The nurse realizes the new employee understands the drug's effect if the new employee explains that this medication is prescribed to treat which condition?

• A. Pain
• B. Depression
• C. Overactive bladder
• D. Chronic anxiety

Correct answer: C

Rationale: The correct answer is C: Overactive bladder. Oxybutynin is prescribed to treat overactive bladder by reducing muscle spasms of the bladder. It is classified as an anticholinergic medication. Choices A, B, and D are incorrect. Oxycodone is an opioid used for pain management. Bupropion is an antidepressant used to treat depression. Buspirone is an anxiolytic used to manage anxiety disorders.

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