Nursing Elites

1. What side effect is a male client likely to experience while receiving furosemide 40mg by mouth?

• A. Difficulty starting urination
• B. Nosebleeds
• C. Muscle cramps
• D. Visual disturbances

Correct answer: C

Rationale: Muscle cramps are a common side effect of furosemide due to its impact on electrolyte levels, especially potassium. Furosemide is a loop diuretic that can lead to potassium depletion, resulting in muscle cramps as one of the manifestations of electrolyte imbalances. Therefore, choices A, B, and D are incorrect. Difficulty starting urination is not a common side effect of furosemide; nosebleeds and visual disturbances are not typically associated with this medication.

2. 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.

3. A practical nurse (PN) is reviewing teaching with the client and/or significant others about the concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should the PN reinforce?

• A. Benztropine will reduce olanzapine's side effect of urinary retention.
• B. Benztropine potentiates the effect of olanzapine.
• C. Benztropine is used to control the side effects of olanzapine.
• D. The combined effect of these drugs will modify psychotic behavior.

Correct answer: C

Rationale: The correct answer is C because benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with olanzapine use. Choice A is incorrect because benztropine does not directly reduce olanzapine's side effect of urinary retention. Choice B is incorrect as benztropine does not potentiate the effect of olanzapine; its main role is to counteract extrapyramidal symptoms. Choice D is incorrect because the primary purpose of using benztropine alongside olanzapine is to manage side effects, not specifically to modify psychotic behavior.

4. A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?

• A. The client is experiencing vision and hearing loss.
• B. The client has an erection lasting longer than 4 hours.
• C. The client is complaining of nasal congestion.
• D. The client is complaining of feeling flushed.

Correct answer: A

Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications. Choices B, C, and D are incorrect because an erection lasting more than 2 hours (not 4 hours as stated in choice B) is a critical adverse effect that warrants immediate medical attention. Nasal congestion (choice C) and feeling flushed (choice D) are common side effects of sildenafil and typically do not necessitate immediate discontinuation of the medication or emergency intervention.

5. A client with chronic pain is prescribed oxycodone. What instruction should the practical nurse (PN) include in the client's teaching plan?

• A. Take the medication with meals to avoid gastrointestinal upset.
• B. Avoid taking the medication with alcohol.
• C. Increase fluid intake to avoid constipation.
• D. Report any signs of respiratory depression to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking oxycodone with alcohol. Mixing oxycodone with alcohol can lead to serious side effects, including respiratory depression. Taking the medication with meals may not always be necessary, and instructions about fluid intake to avoid constipation are important but not the priority when considering the immediate risks associated with oxycodone. While reporting signs of respiratory depression is crucial, preventing it by avoiding alcohol is key in the client's safety.

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