Nursing Elites

1. A client with severe rheumatoid arthritis is prescribed infliximab. The nurse should monitor for which potential adverse effect?

• A. Increased risk of infection
• B. Bone marrow suppression
• C. Hair loss
• D. Pancreatitis

Correct answer: A

Rationale: The correct answer is A: Increased risk of infection. Infliximab is known to increase the risk of infection due to its immunosuppressive effects. It is crucial for the nurse to monitor for signs of infection in the client receiving infliximab to promptly address any potential complications and ensure the client's safety and well-being. Choices B, C, and D are incorrect because bone marrow suppression, hair loss, and pancreatitis are not typically associated with infliximab therapy. While these adverse effects can occur with other medications, the primary concern with infliximab is the increased risk of infection.

2. A client diagnosed with a sinus infection is prescribed ampicillin sodium. The practical nurse (PN) should instruct the client to notify the healthcare provider immediately if which symptom occurs?

• A. Rash
• B. Nausea
• C. Headache
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A - Rash. Rash is the most common adverse side effect of all generations of penicillin, indicating an allergy to the medication. An allergic reaction could lead to anaphylactic shock, a severe and potentially life-threatening emergency. It is crucial for the client to inform the healthcare provider promptly if a rash develops after taking ampicillin sodium.

3. A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse (PN) reinforce to this client?

• A. Maintain consistent sodium intake.
• B. Use sunscreen when outdoors.
• C. Return for monthly urinalysis.
• D. Brush and floss teeth daily.

Correct answer: D

Rationale: The correct answer is to reinforce the instruction to brush and floss teeth daily. Phenytoin therapy can lead to gingival hyperplasia (gum disease), which can be prevented by maintaining good oral hygiene practices such as brushing and flossing daily. Choices A, B, and C are incorrect because they are not directly related to the side effects or management of phenytoin therapy. Maintaining consistent sodium intake is not a specific concern with phenytoin. Using sunscreen when outdoors is important to prevent sunburn but is not directly related to phenytoin therapy. Returning for monthly urinalysis may be necessary for other medications, but it is not specifically required for monitoring phenytoin therapy.

4. A client diagnosed with angina has been prescribed nitrate isosorbide dinitrate. Which instruction should the practical nurse reinforce in this client's teaching?

• A. Discontinue the medication if dizziness occurs.
• B. Avoid getting up quickly. Always rise slowly.
• C. Take the medication with or without food.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction that the practical nurse should reinforce with a client prescribed nitrate isosorbide dinitrate is to avoid getting up quickly and to rise slowly. Nitrates can cause orthostatic hypotension, a sudden drop in blood pressure when changing positions. By rising slowly, the client can prevent the occurrence of orthostatic hypotension and its associated symptoms. Choices A, C, and D are incorrect because discontinuing the medication without consulting a healthcare provider can be dangerous, taking the medication with or without food does not impact its effectiveness, and increasing potassium intake is not directly related to the use of nitrate isosorbide dinitrate.

5. A client who was diagnosed with oral thrush calls the clinic saying the medication bottle broke and all of the medication was spilled. The client is requesting a refill order. The nurse should contact the health care provider about a refill for which medication?

• A. Ampicillin
• B. Ciprofloxacin
• C. Neomycin sulfate
• D. Nystatin

Correct answer: D

Rationale: Nystatin is the appropriate medication for treating oral thrush as it is an antifungal drug specifically used for fungal infections. It targets the fungus responsible for thrush, Candida, effectively. Therefore, the nurse should contact the healthcare provider to request a refill of Nystatin for the client.

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