Nursing Elites

1. A client with rheumatoid arthritis is prescribed methotrexate. What is the most important instruction the practical nurse (PN) should provide to the client?

• A. Take the medication on an empty stomach.
• B. Avoid taking folic acid supplements.
• C. Report any signs of infection immediately.
• D. Increase intake of vitamin C-rich foods.

Correct answer: C

Rationale: Correct Answer: The most important instruction for a client taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. Early detection and treatment of infections are crucial to prevent complications. Instructing the client to be vigilant for signs of infection empowers them to take prompt action, enhancing their overall safety and well-being.

2. A client with a history of deep vein thrombosis is prescribed edoxaban. 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: The correct answer is A: Increased risk of bleeding. Edoxaban is an anticoagulant that works by inhibiting clot formation, thereby increasing the risk of bleeding. Therefore, the nurse should closely monitor the client for signs of bleeding, such as bruising, petechiae, hematuria, or gastrointestinal bleeding, to prevent potential complications. Choices B, C, and D are incorrect because edoxaban does not decrease the risk of bleeding or affect the risk of infection; its primary concern is the potential for bleeding due to its anticoagulant properties.

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

• A. Pulmonary toxicity
• B. Liver toxicity
• C. Thyroid dysfunction
• D. Bradycardia

Correct answer: A

Rationale: Corrected Rationale: Amiodarone is known to cause pulmonary toxicity, which can manifest as respiratory symptoms. Monitoring for signs such as cough, dyspnea, or chest pain is essential to detect this serious side effect early and prevent further complications. Choices B, C, and D are incorrect because while amiodarone can also cause liver toxicity, thyroid dysfunction, and bradycardia, pulmonary toxicity is the most serious side effect that requires immediate attention due to its potential life-threatening consequences.

4. The healthcare provider has administered albuterol as an inhaled medication. The healthcare provider should monitor the client for which possible adverse reaction?

• A. Enuresis
• B. Lethargy
• C. Depression
• D. Tachycardia

Correct answer: D

Rationale: Albuterol is a bronchodilator in the adrenergic category. Its actions and adverse effects are similar to adrenaline or epinephrine. The healthcare provider should monitor the client for tachycardia, which is a common adverse effect of albuterol due to its stimulant effect on beta-2 receptors. Enuresis, or night bed-wetting, is not an adverse effect associated with albuterol. Additionally, the client should be monitored for anxiety as a potential adverse effect, not lethargy or depression, which are not typically associated with albuterol administration.

5. A client with chronic obstructive pulmonary disease (COPD) is prescribed albuterol. The nurse should monitor for which potential side effect?

• A. Tachycardia
• B. Nausea
• C. Dry mouth
• D. Weight gain

Correct answer: A

Rationale: Correct Answer: A. Albuterol, a bronchodilator commonly used in COPD, can cause tachycardia as a potential side effect due to its beta-agonist properties that can stimulate the heart. Nausea (Choice B), dry mouth (Choice C), and weight gain (Choice D) are less likely associated with albuterol use. Nausea and dry mouth are not common side effects of albuterol, and weight gain is not typically linked to its use. Therefore, the nurse should primarily monitor for tachycardia when a client is prescribed albuterol for COPD.

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