Nursing Elites

1. A client with epilepsy is prescribed lamotrigine. The nurse should monitor for which potential side effect?

• A. Drowsiness
• B. Nausea and vomiting
• C. Skin rash
• D. Dizziness

Correct answer: C

Rationale: When a client is prescribed lamotrigine, the nurse should closely monitor for the potential side effect of skin rash. Lamotrigine is known to cause skin rashes, which can be mild or severe, indicating a serious adverse reaction like Stevens-Johnson syndrome. Monitoring for skin rash is crucial to detect any signs of severe allergic reactions early and prevent further complications. Choices A, B, and D are incorrect as drowsiness, nausea and vomiting, and dizziness are not typically associated with lamotrigine use. While dizziness can be a side effect of some antiepileptic medications, it is not a common side effect of lamotrigine.

2. A client with rheumatoid arthritis is prescribed hydroxychloroquine. What instruction should the nurse include in the client's teaching plan?

• A. Avoid sunlight exposure while taking this medication.
• B. Take this medication with food to reduce gastrointestinal upset.
• C. Report any signs of infection to the healthcare provider.
• D. Report any signs of vision changes to the healthcare provider.

Correct answer: D

Rationale: Hydroxychloroquine is known to cause vision changes, including retinopathy. Therefore, it is crucial for clients to report any vision changes promptly to their healthcare provider to prevent any potential ocular complications. While sunlight exposure should be limited due to photosensitivity, the key concern with hydroxychloroquine is the risk of vision changes, not gastrointestinal upset or infections.

3. The healthcare professional is caring for a patient with a new order for an oral laxative. Which is a contraindication in administering an oral laxative?

• A. Cardiac problems
• B. Abdominal pain of unknown origin
• C. Several hemorrhoids
• D. Chronic constipation

Correct answer: B

Rationale: Administering an oral laxative to a patient with abdominal pain of unknown origin is contraindicated because it could be a sign of a more serious underlying condition that needs immediate medical evaluation. Giving a laxative in such a situation without proper diagnosis could potentially worsen the patient's condition or delay appropriate treatment. Choice A (Cardiac problems) is not a contraindication for an oral laxative unless the patient has a specific cardiac condition that interacts with the laxative. Choice C (Several hemorrhoids) and Choice D (Chronic constipation) are not contraindications for administering an oral laxative.

4. A client with a history of atrial fibrillation is prescribed apixaban. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: The correct answer is A: Bleeding. Apixaban is an anticoagulant medication that works by decreasing the blood's ability to clot. One of the significant side effects of apixaban is an increased risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in the urine or stool, or unusual bleeding or bruising. Monitoring for these signs is crucial to prevent or manage any potential complications associated with the medication. Choices B, C, and D are incorrect because weight gain, headache, and nausea are not typically associated with apixaban use. Therefore, the nurse should primarily focus on monitoring for signs of bleeding in a client prescribed apixaban.

5. A client with a diagnosis of depression is prescribed escitalopram. Which statement by the client indicates the need for further teaching?

• A. I should take this medication in the morning with food.
• B. This medication may take 1 to 4 weeks to notice improvement in symptoms.
• C. I can stop taking this medication once I feel better.
• D. This medication might make me feel drowsy.

Correct answer: C

Rationale: It is crucial for clients to understand that they should not discontinue escitalopram abruptly, even if they start feeling better. Stopping the medication suddenly can lead to withdrawal symptoms or a relapse of depression. It is essential to complete the full course of treatment as prescribed by the healthcare provider to ensure the best outcomes and prevent potential complications.

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