Nursing Elites

1. A client with major depressive disorder is prescribed bupropion. Which statement by the client indicates the need for further teaching?

• A. This medication may cause weight gain.
• B. This medication may take several weeks to take effect.
• C. I should avoid alcohol while taking this medication.
• D. I should take this medication in the morning with food.

Correct answer: A

Rationale: The correct answer is A because bupropion is associated with weight loss rather than weight gain. It is important for the client to be aware of this potential side effect. Choice B is correct because bupropion may take several weeks to exhibit its full therapeutic effects. Choice C is also accurate as alcohol consumption should be avoided while taking bupropion due to the risk of seizures. Choice D is correct as taking bupropion in the morning with food can help reduce the risk of gastrointestinal side effects.

2. A client with a diagnosis of bipolar disorder is prescribed topiramate. The nurse should monitor for which potential adverse effect?

• A. Cognitive impairment
• B. Weight gain
• C. Liver toxicity
• D. Weight loss

Correct answer: A

Rationale: Correct. Topiramate is associated with cognitive impairment as an adverse effect. It is important for the nurse to monitor the client's cognitive function while on this medication to assess for any signs of cognitive decline or impairment. Choice B, weight gain, is incorrect as topiramate is actually associated with weight loss rather than weight gain. Choice C, liver toxicity, is also incorrect as topiramate is not known to cause liver toxicity. Choice D, weight loss, is not the correct answer as topiramate is not associated with weight gain.

3. Which nursing intervention is most important when caring for a client receiving aspirin 600mg po QID?

• A. Monitor temperature q4h
• B. Use 10-point pain scale to assess pain
• C. Assess for dyspepsia and nausea
• D. Check stool for occult blood

Correct answer: D

Rationale: The correct answer is to check the stool for occult blood when caring for a client receiving aspirin 600mg po QID. Aspirin can lead to gastrointestinal bleeding, and checking for occult blood in the stool is essential to monitor for this serious adverse effect. Monitoring temperature, assessing pain, and checking for dyspepsia and nausea are important interventions but not as critical as monitoring for gastrointestinal bleeding when a client is receiving aspirin.

4. A client with angina pectoris has been prescribed nitroglycerin tablets prn for chest pain. Which statement by the client causes the practical nurse (PN) to clarify instructions for this client?

• A. I will take one tablet every 5 minutes, up to three tablets.
• B. I should take one tablet at the onset of angina and stop activity.
• C. I need to replace nitroglycerin tablets every 3 to 6 months to maintain freshness.
• D. I should ensure that I chew the pill completely before swallowing it.

Correct answer: D

Rationale: Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest. One tablet should be placed under the tongue (sublingually), not chewed or swallowed. One tablet can be taken every 5 minutes, up to three doses. If pain relief not achieved after taking three pills, seek medical attention immediately. Nitroglycerin should be replaced every 3 to 6 months. Nitroglycerin pain relief should occur in 5 minutes and duration should last 30 minutes.

5. When a client with a history of deep vein thrombosis is prescribed fondaparinux, the nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: Fondaparinux is an anticoagulant prescribed to prevent blood clots. Therefore, the nurse should monitor the client for an increased risk of bleeding, which is a potential adverse effect of this medication. Choices B, C, and D are incorrect because fondaparinux does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for signs of bleeding, such as unexplained bruising, bleeding gums, or blood in the urine or stool, is crucial when a client is on fondaparinux.

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