Nursing Elites

1. A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Thrombophlebitis
• B. Hyperactive reflexes
• C. Muscle weakness
• D. Hypoglycemia

Correct answer: C

Rationale: The correct answer is C: Muscle weakness. Chlorothiazide, a thiazide diuretic, can lead to hypokalemia, which can cause muscle weakness. Thrombophlebitis (choice A) is not typically associated with chlorothiazide use. Hyperactive reflexes (choice B) and hypoglycemia (choice D) are also not commonly linked to this medication. Therefore, monitoring for muscle weakness is crucial when a client is prescribed chlorothiazide.

2. A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering?

• A. Amantadine
• B. Bupropion
• C. Phenelzine
• D. Hydroxyzine

Correct answer: A

Rationale: The correct answer is Amantadine. Amantadine is used to treat extrapyramidal symptoms, such as mask-like facial expressions, involuntary movements, and tremors, which are common side effects of antipsychotic medications like chlorpromazine. Bupropion is an antidepressant and not indicated for treating these symptoms. Phenelzine is a monoamine oxidase inhibitor used for depression and anxiety disorders, not for extrapyramidal symptoms. Hydroxyzine is an antihistamine used for anxiety and allergic conditions, not for the side effects described in the client.

3. A client with a seizure disorder has a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply)

• A. PTT
• B. Aspartate aminotransferase (AST)
• C. Alanine aminotransferase (ALT)
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D, 'All of the Above.' Valproic acid can impact liver function and coagulation. Monitoring the Prothrombin Time (PTT), Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) is crucial. PTT is monitored to assess coagulation status, while AST and ALT are liver enzymes that indicate liver function. Monitoring these values helps detect any potential adverse effects of valproic acid on the liver and blood clotting. Choices A, B, and C are incorrect because each of these laboratory values plays a critical role in evaluating the client's response to valproic acid therapy and detecting associated complications.

4. A nurse is providing discharge teaching to a client who has heart failure and a new prescription for digoxin 0.215 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?

• A. I know that blurred vision is something I will expect to happen while taking digoxin.
• B. I will measure my urine output each day and document it in my diary.
• C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute.
• D. I will eat fruits and vegetables that have high potassium content every day.

Correct answer: D

Rationale: Clients taking digoxin and furosemide are at risk for hypokalemia. Eating potassium-rich foods can help maintain normal potassium levels.

5. A client with rheumatoid arthritis is prescribed long-term prednisone therapy. What adverse effect should the client monitor for according to the nurse's instruction?

• A. Stress fractures
• B. Orthostatic hypotension
• C. Gingival ulcerations
• D. Weight loss

Correct answer: A

Rationale: The correct answer is A: Stress fractures. Long-term prednisone therapy can lead to osteoporosis, which increases the risk of stress fractures. Option B, orthostatic hypotension, is not a common adverse effect associated with prednisone use. Option C, gingival ulcerations, is more commonly associated with conditions like periodontal disease or poor oral hygiene rather than prednisone therapy. Option D, weight loss, is not a typical adverse effect of prednisone; in fact, weight gain is more common due to prednisone's impact on metabolism.

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