Nursing Elites

1. A client has a new prescription for Amlodipine. Which of the following side effects should the client monitor for and report?

• A. Swelling of the ankles.
• B. Increased urination.
• C. Persistent cough.
• D. Dark-colored urine.

Correct answer: A

Rationale: Corrected Rationale: Amlodipine, a calcium channel blocker, can cause peripheral edema (swelling of the ankles) as a side effect. This occurs due to the dilation of blood vessels and increased fluid retention. It is important for the client to monitor for ankle swelling as it could indicate a potential adverse reaction to the medication. Reporting this side effect to the healthcare provider is crucial to ensure appropriate management and potential adjustment of the treatment plan.\n Choice B, increased urination, is not a common side effect of Amlodipine. Choice C, persistent cough, is more commonly associated with ACE inhibitors rather than calcium channel blockers like Amlodipine. Choice D, dark-colored urine, is not a typical side effect of Amlodipine and is not something the client should specifically monitor for and report while taking this medication.

2. A client is taking metformin for type 2 diabetes. Which of the following findings should indicate to the nurse that the medication is effective?

• A. Increased urine output
• B. Decreased fasting blood glucose
• C. Decreased hemoglobin A1C
• D. Decreased polyuria

Correct answer: C

Rationale: A decrease in hemoglobin A1C is a more specific indicator of metformin's effectiveness in controlling blood glucose levels over a longer period compared to fasting blood glucose levels. Hemoglobin A1C reflects average blood sugar levels over the past 2-3 months, providing a more comprehensive view of glycemic control. Increased urine output (choice A) is not a direct indicator of metformin's effectiveness and can be influenced by various factors. Decreased fasting blood glucose (choice B) can fluctuate due to various reasons and may not provide a reliable long-term assessment of metformin's efficacy. Decreased polyuria (choice D) refers to a symptom rather than a direct measure of metformin's effectiveness in managing diabetes.

3. The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?

• A. Atenolol (Tenormin)
• B. Nitroglycerin (Nitrostat)
• C. Sildenafil (Viagra)
• D. Ranolazine (Ranexa)

Correct answer: D

Rationale: In cases of chronic angina where initial treatment has not been successful, Ranolazine (Ranexa) is often prescribed. This medication helps by reducing the frequency of angina episodes. Atenolol, Nitroglycerin, and Sildenafil are also used in angina management but Ranolazine is more specifically indicated in cases of refractory angina where other treatments have failed.

4. A healthcare provider is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare provider should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders that can be caused by certain medications affecting the central nervous system, such as typical antipsychotic medications. These effects can lead to symptoms like tremors, muscle rigidity, and involuntary movements, which are all related to disruptions in the central nervous system. Choices A, B, and D are incorrect because extrapyramidal effects are specifically associated with the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

5. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?

• A. This medication can stain your contacts.
• B. This medication can cause your pupils to constrict.
• C. This medication can absorb into your contacts.
• D. This medication can slow your heart rate.

Correct answer: C

Rationale: The correct answer is C. Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove their contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid potential absorption of the medication by the lenses. Choices A, B, and D are incorrect because Brimonidine's main concern with contact lenses is its absorption into the lenses rather than staining contacts, causing pupil constriction, or affecting heart rate.

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