Nursing Elites

1. A nurse is assessing a client who has a new prescription for enalapril. Which of the following findings is a priority for the nurse to report to the provider?

• A. Frequent urination
• B. Dry cough
• C. Tremors
• D. Dizziness

Correct answer: D

Rationale: The correct answer is D: Dizziness. Dizziness is a sign of hypotension, a potential adverse effect of enalapril. Enalapril is an ACE inhibitor commonly prescribed for hypertension. Hypotension is a serious side effect that can lead to complications such as falls and injuries. Reporting dizziness promptly is crucial to prevent any harm to the client. Choices A, B, and C are not directly associated with enalapril use and are less concerning compared to the potential implications of hypotension indicated by dizziness.

2. When teaching a client who has a new prescription for metformin, which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Increase your fluid intake.
• D. Expect a metallic taste in your mouth.

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration helps reduce the risk of gastrointestinal upset and ensures the medication is well-tolerated. Option A is generally true for metformin but is not as essential as maintaining proper hydration. Option B is important but not directly related to starting metformin. Option D is incorrect as a metallic taste in the mouth is not typically associated with metformin.

3. A client with a history of coronary artery disease is prescribed atorvastatin (Lipitor). What side effect should the nurse instruct the client to immediately report?

• A. Muscle pain or tenderness
• B. Constipation
• C. Dry mouth
• D. Drowsiness

Correct answer: A

Rationale: The correct answer is 'Muscle pain or tenderness.' This can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin (Lipitor). Rhabdomyolysis is a condition in which muscle breakdown releases a protein that can damage the kidneys. Therefore, it is crucial for the client to report any muscle pain or tenderness immediately to prevent further complications. Choices B, C, and D are incorrect because they are not typically associated with atorvastatin (Lipitor) use or indicative of a serious adverse effect that requires immediate reporting.

4. A client is taking levothyroxine for hypothyroidism. Which of the following findings should indicate to the healthcare provider that the client is experiencing levothyroxine toxicity?

• A. Weight loss
• B. Insomnia
• C. Heat intolerance
• D. Dry skin

Correct answer: C

Rationale: Heat intolerance is a hallmark sign of levothyroxine toxicity. It indicates that the client may be receiving an excessive dose of levothyroxine, leading to hyperthyroid symptoms. This can happen when the dosage is too high, causing the body to have an excess of thyroid hormone. Weight loss is a common symptom of hyperthyroidism but alone does not specifically indicate levothyroxine toxicity. Insomnia can be related to hyperthyroidism but is not a specific sign of levothyroxine toxicity. Dry skin is more commonly associated with hypothyroidism rather than levothyroxine toxicity.

5. A client has a new prescription for methotrexate. Which of the following instructions should the nurse include?

• A. Avoid consuming dairy products.
• B. Take the medication on an empty stomach.
• C. Increase your intake of folic acid.
• D. Monitor for signs of hyperglycemia.

Correct answer: C

Rationale: Increasing folic acid intake is crucial when taking methotrexate because the medication can lead to folic acid deficiency. Folic acid supplementation helps counteract this deficiency and reduces the risk of adverse effects associated with methotrexate therapy. Choices A, B, and D are incorrect. Avoiding dairy products is not specifically necessary for methotrexate therapy. Methotrexate is usually taken with food to reduce gastrointestinal side effects, so taking it on an empty stomach is not recommended. Monitoring for signs of hyperglycemia is not directly related to methotrexate use.

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