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. Escitalopram is prescribed for a 16-year-old adolescent client who is clinically depressed. Five days later, the parent tells the practical nurse (PN) that the drug is not working because their child is not feeling any better. Which explanation should the PN provide?

• A. It takes 1 to 4 weeks for antidepressant medications to become effective.
• B. The dosage may need to be increased; I will contact your health care provider.
• C. Depression is difficult to treat with drugs alone. Therapy sessions would enhance their effectiveness.
• D. Based on your child's response to this drug, the health care provider is reviewing your medication regimen.

Correct answer: A

Rationale: Antidepressant medications typically require 1 to 4 weeks to reach their full therapeutic effect. It is crucial to educate the family that during the initial week of treatment, the child may experience heightened anxiety. Therefore, it is important to wait for the medication to take its full course before assessing its effectiveness.

3. A client with a history of hypertension is prescribed hydrochlorothiazide. The practical nurse should monitor the client for which potential adverse effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: B

Rationale: Corrected Rationale: Hydrochlorothiazide is a diuretic that can lead to potassium loss, resulting in hypokalemia. Monitoring for hypokalemia is essential because it can cause various complications such as cardiac dysrhythmias. Therefore, the practical nurse should closely watch for signs and symptoms of low potassium levels in clients taking hydrochlorothiazide. Incorrect Rationale for Other Choices: A. Hyperkalemia is not typically associated with hydrochlorothiazide use; instead, it is more commonly linked to medications like ACE inhibitors or potassium-sparing diuretics. C. Hypernatremia is unlikely with hydrochlorothiazide use as it tends to cause sodium loss. D. Hyponatremia is more commonly associated with conditions where there is excessive water intake or syndrome of inappropriate antidiuretic hormone secretion (SIADH), rather than with hydrochlorothiazide use.

4. A client with diabetes mellitus type 2 is prescribed linagliptin. Which instruction should the nurse include in the client's teaching plan?

• A. Report any signs of pancreatitis to the healthcare provider.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of heart failure to the healthcare provider.

Correct answer: A

Rationale: When a client is prescribed linagliptin, it is crucial to educate them to report any signs of pancreatitis to their healthcare provider. Linagliptin can lead to pancreatitis, making it essential for clients to be vigilant for symptoms such as severe abdominal pain, nausea, and vomiting. Timely reporting of these symptoms can aid in early intervention and management of pancreatitis.

5. A client is prescribed an antibiotic for a urinary tract infection (UTI). What instruction should the practical nurse provide to the client to ensure the effectiveness of the medication?

• A. Take the medication with food.
• B. Increase fluid intake.
• C. Complete the full course of the medication.
• D. Avoid dairy products.

Correct answer: C

Rationale: The practical nurse should instruct the client to complete the full course of the antibiotic to ensure the infection is fully treated and to prevent the development of antibiotic resistance. Completing the full course of antibiotics helps to eradicate the infection completely and reduces the risk of bacteria developing resistance to the medication. Choices A, B, and D are not directly related to ensuring the effectiveness of the antibiotic. While taking medication with food or increasing fluid intake can be beneficial in general, the crucial instruction in this case is to complete the full course of the antibiotic.

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