Nursing Elites

1. 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.

2. A client has a new prescription for Hydroxychloroquine to treat Lupus Erythematosus. Which of the following adverse effects should the nurse include in the teaching?

• A. Nausea
• B. Hair loss
• C. Eye damage
• D. Drowsiness

Correct answer: C

Rationale: The correct answer is 'C: Eye damage.' Hydroxychloroquine can cause severe adverse effects on the eyes, such as retinopathy, which can lead to permanent visual impairment. It is essential for clients to be aware of this potential adverse effect and report any changes in vision promptly. Choices A, B, and D are incorrect because although nausea, hair loss, and drowsiness can occur with Hydroxychloroquine, they are not as severe or critical as the risk of eye damage.

3. When starting therapy with cisplatin, a client should report which of the following adverse effects as instructed by the nurse?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The nurse should instruct the client to report tinnitus because it can be an indication of ototoxicity, a potential adverse effect of cisplatin. Ototoxicity can manifest as tinnitus, hearing loss, or balance disturbances, so it is crucial for the client to promptly report any changes in hearing such as tinnitus to prevent further damage.

4. A healthcare professional is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare professional should monitor the client for which of the following as an adverse effect of this medication?

• A. Bradycardia
• B. Hyperkalemia
• C. Hypoglycemia
• D. Hypocalcemia

Correct answer: B

Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, which leads to potassium retention. Monitoring potassium levels is essential to prevent potential complications associated with hyperkalemia. The other options, bradycardia, hypoglycemia, and hypocalcemia, are not typically associated with Enalapril use and are less likely to occur as adverse effects.

5. The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?

• A. “I will check my weight regularly for any gain or loss.”
• B. “I’ll make sure to take my high blood pressure medications.”
• C. “I am attending a smoking cessation class.”
• D. “As long as I exercise, stress at my job will not bother me.”

Correct answer: D

Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.

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