Nursing Elites

1. A client with hypertension is prescribed metoprolol. The healthcare provider should monitor the client for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: A

Rationale: Metoprolol is a beta-blocker that works by slowing the heart rate and reducing blood pressure. One of the potential side effects of metoprolol is bradycardia, which is a slow heart rate. Monitoring for bradycardia is crucial as it can be an adverse effect of this medication.

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

• A. Constipation
• B. Diarrhea
• C. Headache
• D. Hypotension

Correct answer: A

Rationale: Verapamil, a calcium channel blocker, can commonly cause constipation due to its effects on smooth muscle relaxation in the gastrointestinal tract. Therefore, monitoring for constipation is important when a client is prescribed verapamil.

3. A client with chronic kidney disease is prescribed lanthanum carbonate. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: A

Rationale: Lanthanum carbonate is prescribed in chronic kidney disease to bind dietary phosphorus in the gastrointestinal tract. This action can lead to decreased phosphorus absorption and potential hypercalcemia due to the increased serum calcium levels. Therefore, the nurse should monitor the client for signs and symptoms of hypercalcemia, such as confusion, fatigue, and muscle weakness. Choices B, C, and D are incorrect as lanthanum carbonate's mechanism of action does not lead to hypocalcemia, hyperkalemia, or hypokalemia.

4. The healthcare provider has prescribed an influenza vaccine for a 74-year-old client before discharge. Which client condition would prompt the practical nurse to consult with the charge nurse rather than administer the vaccine?

• A. History of congestive heart failure
• B. History of an egg allergy
• C. History of pneumococcal vaccination
• D. History of end-stage renal disease

Correct answer: B

Rationale: The correct answer is B: History of an egg allergy. The influenza vaccine may contain a small amount of egg protein. According to the CDC, individuals with a severe allergy to any component of the vaccine, including egg protein, should not receive the influenza vaccine. Therefore, if the client has a history of an allergy to eggs, the practical nurse should not administer the vaccine and consult with the charge nurse for further guidance, as it is a contraindication. The other conditions listed do not require consultation before administering the influenza vaccine.

5. Phenytoin is prescribed for a client who has a seizure disorder. Which statement by the client needs to be clarified by the healthcare provider?

• A. I should notify the healthcare provider if the color of my urine turns pink.
• B. I should never stop taking this medication abruptly.
• C. I should monitor my glucose levels closely since I am diabetic.
• D. I should take the medicine with antacids if gastric upset occurs.

Correct answer: D

Rationale: The correct answer is D because antacids should not be taken with phenytoin as they can decrease its effects. Taking antacids with phenytoin is not recommended. Choice A is correct; pink discoloration of urine can occur with phenytoin use. Choice B is also correct; abruptly stopping phenytoin can lead to seizures. Choice C is correct; monitoring glucose levels is important as phenytoin can increase glucose levels. Therefore, the statement about using antacids with phenytoin needs clarification.

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