Nursing Elites

1. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.

2. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin sublingual tablets involves taking one tablet at the onset of chest pain and repeating every 5 minutes for up to three doses. This protocol helps in managing angina episodes effectively. Choice A suggests taking a tablet every 15 minutes until pain relief, which may delay appropriate intervention. Choice C, taking a tablet at bedtime, is not suitable for immediate relief during angina attacks. Choice D, taking a tablet on an empty stomach, is unrelated to the correct administration of Nitroglycerin sublingual tablets.

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 the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

5. A client has a new prescription for Oxycodone/Acetaminophen, and the nurse is providing discharge instructions. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid taking additional Acetaminophen while on this medication.
• C. Increase your intake of fiber while on this medication.
• D. Avoid taking the medication before bedtime.

Correct answer: B

Rationale: The correct instruction for a client with a prescription for Oxycodone/Acetaminophen is to avoid taking additional Acetaminophen while on this medication. Combining medications containing Acetaminophen can lead to exceeding the maximum recommended dose and increase the risk of liver toxicity. Therefore, it is crucial for the nurse to emphasize the importance of not taking extra Acetaminophen while on this prescription to ensure the client's safety and well-being. Choices A, C, and D are incorrect. Taking Oxycodone/Acetaminophen on an empty stomach is not necessary; increasing fiber intake is not directly related to this medication, and avoiding taking the medication before bedtime is not a specific concern associated with this prescription.

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