Nursing Elites

1. A client is prescribed Propylthiouracil (PTU) for the treatment of Graves' disease. Which adverse effect should the client be instructed to report?

• A. Sore throat.
• B. Drowsiness.
• C. Urinary retention.
• D. Heat intolerance.

Correct answer: A

Rationale: The correct answer is A: Sore throat. A sore throat and fever can indicate agranulocytosis, a serious adverse effect of PTU that can lead to a decreased white blood cell count. This condition requires immediate medical attention to prevent complications. Choice B, drowsiness, is not typically associated with PTU and is not a common adverse effect that needs to be reported. Choice C, urinary retention, is not a typical adverse effect of PTU; therefore, it is not the correct answer. Choice D, heat intolerance, is a symptom commonly seen in hyperthyroidism, which PTU is used to treat, so it is not an adverse effect that needs to be specifically reported.

2. A client has a prescription for digoxin. The client should be monitored for which of the following findings as an indication of digoxin toxicity?

• A. Visual disturbances
• B. Tachycardia
• C. Increased appetite
• D. Constipation

Correct answer: A

Rationale: Visual disturbances, such as yellow-tinged vision or seeing halos around lights, are common signs of digoxin toxicity. These symptoms should be reported immediately to healthcare providers for further evaluation and management. Tachycardia (Choice B) is not typically associated with digoxin toxicity. Increased appetite (Choice C) and constipation (Choice D) are not common manifestations of digoxin toxicity. Therefore, the correct answer is visual disturbances.

3. A client has been prescribed Alendronate for osteoporosis. Which of the following instructions should the nurse provide?

• A. Take the medication with a full glass of water after getting up in the morning.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Chew the tablet and mix it with applesauce if swallowing is difficult.
• D. Take the medication at bedtime to minimize the chance of esophageal irritation.

Correct answer: A

Rationale: The correct instruction for a client prescribed Alendronate for osteoporosis is to take the medication with a full glass of water after getting up in the morning. This is important to reduce the risk of esophageal irritation. Choice B is also correct as remaining upright for at least 30 minutes after taking the medication helps prevent esophageal irritation and ensures proper absorption. Choice C is incorrect because Alendronate tablets should not be chewed or mixed with any other substance. Choice D is incorrect as taking the medication at bedtime increases the risk of esophageal irritation due to lying down after ingestion.

4. A client with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.

5. A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Dry mouth
• C. Insomnia
• D. Hypertension

Correct answer: B

Rationale: Dry mouth is a common adverse effect associated with Clonidine use. Clonidine is known to cause a reduction in saliva production, leading to dry mouth. Monitoring for this adverse effect is essential to ensure client comfort and compliance with the medication. Diarrhea is not a common adverse effect of Clonidine. Insomnia is more commonly associated with opioid withdrawal rather than Clonidine use. While Clonidine is used to treat hypertension, it is not typically an adverse effect of the medication.

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