Nursing Elites

1. A client has a prescription for hydrochlorothiazide to treat hypertension. The nurse should monitor the client for which of the following adverse effects?

• A. Hypokalemia
• B. Hypertension
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: Hydrochlorothiazide is a diuretic that can cause potassium loss, leading to hypokalemia. Monitoring potassium levels is crucial to prevent potential adverse effects such as cardiac arrhythmias and muscle weakness.

2. A school-age child has a new prescription for Atomoxetine. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Kidney toxicity
• B. Liver damage
• C. Seizure activity
• D. Adrenal insufficiency

Correct answer: B

Rationale: Liver damage is an adverse effect of Atomoxetine. The nurse should monitor for manifestations such as jaundice, upper abdominal tenderness, darkening of urine, and elevated liver enzymes. It is crucial to be vigilant for signs of liver damage to ensure early detection and intervention to prevent further complications. Kidney toxicity is not a common adverse effect of Atomoxetine. Seizure activity and adrenal insufficiency are also not typically associated with this medication.

3. When teaching a client with a new prescription for Warfarin, which herbal supplement should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: The correct answer is St. John's wort. St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism, potentially leading to decreased anticoagulant effects. Therefore, the nurse should instruct the client to avoid using St. John's wort while taking Warfarin to prevent adverse drug interactions. Echinacea, garlic, and ginseng are not the correct answers in this case. While these herbal supplements may also interact with Warfarin and affect its efficacy, St. John's wort has a well-known interaction with Warfarin that can significantly impact its anticoagulant effects. Educating the client about the specific interaction between St. John's wort and Warfarin is crucial to ensure patient safety and the medication's therapeutic benefit.

4. A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?

• A. Taking four medications decreases the risk of a severe allergic reaction.
• B. Taking four medications reduces the chance that the bacteria will become resistant.
• C. Taking four medications reduces the risk of adverse reactions.
• D. Taking four medications decreases the chance of having a positive tuberculin skin test.

Correct answer: B

Rationale: When treating tuberculosis, using a combination of multiple medications is crucial to reduce the risk of bacterial resistance. The use of four medications helps to target the bacteria from different angles, making it harder for them to develop resistance to the treatment. This approach is essential to ensure the effectiveness of the treatment regimen and to prevent the spread of drug-resistant strains of tuberculosis. Choices A, C, and D are incorrect because the primary reason for using multiple medications in tuberculosis treatment is to prevent the development of bacterial resistance, not to decrease the risk of allergic reactions, adverse reactions, or affecting the tuberculin skin test results.

5. When administering Lithium to a patient, what is a life-threatening side effect?

• A. Erythema
• B. Pancreatitis
• C. Seizures
• D. Headache

Correct answer: C

Rationale: When a patient is being treated with Lithium, a life-threatening side effect to watch out for is seizures. Lithium can lower the seizure threshold, increasing the risk of seizures. Seizures are serious and necessitate prompt medical intervention to ensure the patient's safety and well-being. Erythema, which is redness of the skin, is not a common life-threatening side effect of Lithium. Pancreatitis can be a side effect of Lithium, but it is not typically life-threatening. Headache is a common side effect of Lithium, but it is not considered life-threatening.

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