Nursing Elites

1. A client with deep vein thrombosis (DVT) is receiving anticoagulant therapy. The nurse should reinforce with the client the importance of reporting which potential side effect?

• A. Nausea
• B. Headache
• C. Gingival bleeding
• D. Dizziness

Correct answer: C

Rationale: The correct answer is C, 'Gingival bleeding.' Gingival bleeding is a common side effect of anticoagulant therapy. Anticoagulants work by prolonging the time it takes for blood to clot, which can lead to bleeding issues, including gingival bleeding. Nausea, headache, and dizziness are not typically associated with anticoagulant therapy. Since bleeding, including gingival bleeding, can be a serious side effect that requires medical attention, the client should be educated on reporting it promptly to their healthcare provider.

2. The nurse is caring for a client with hypertension who is prescribed enalapril (Vasotec). The nurse should monitor the client for which potential adverse effect?

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

Correct answer: B

Rationale: The correct answer is B: Hypotension. Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, a potential adverse effect of enalapril is hypotension, not hypertension (choice A), tachycardia (choice C), or hyperglycemia (choice D). Monitoring for hypotension is crucial to prevent complications.

3. A client has a new prescription for alendronate. Which of the following instructions should be included in the teaching?

• A. Take the medication with a full glass of water.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication at bedtime.
• D. Avoid dairy products while taking the medication.

Correct answer: A

Rationale: The correct instruction for taking alendronate is to take it with a full glass of water to prevent esophageal irritation. This helps ensure proper absorption and reduces the risk of irritation to the esophagus. Choice B is incorrect because patients should remain upright for at least 30 minutes after taking alendronate to prevent esophageal irritation. Choice C is incorrect as alendronate should be taken in the morning on an empty stomach. Choice D is also incorrect as there is no specific requirement to avoid dairy products while taking alendronate.

4. The healthcare provider is monitoring a client with left-sided heart failure. Which assessment finding indicates that the client's condition is worsening?

• A. Clear lung sounds
• B. Increased peripheral pulses
• C. Bibasilar crackles
• D. Improved activity tolerance

Correct answer: C

Rationale: Bibasilar crackles are abnormal lung sounds that indicate fluid accumulation in the lungs, a sign that left-sided heart failure is worsening. This finding suggests that the client's condition is deteriorating and requires prompt intervention to prevent further complications. Clear lung sounds (Choice A) are normal and would not indicate worsening heart failure. Increased peripheral pulses (Choice B) may be seen in conditions like anxiety or exercise, but not specifically in worsening left-sided heart failure. Improved activity tolerance (Choice D) would be a positive sign, not an indicator of worsening heart failure.

5. The client is receiving enalapril (Vasotec). The nurse should monitor the client for which potential adverse effect?

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

Correct answer: B

Rationale: Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, monitoring for hypotension is crucial as it can be a potential adverse effect of this medication. Hypertension, tachycardia, and hyperglycemia are not typically associated with enalapril use. Hypertension is the condition enalapril is used to treat, so it would not be an adverse effect. Tachycardia is not a common adverse effect of enalapril. Enalapril does not typically cause hyperglycemia, as it primarily affects blood pressure regulation.

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