Nursing Elites

1. A client with Depression has a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)

• A. Cough
• B. Dizziness
• C. Decreased libido
• D. B and C

Correct answer: D

Rationale: The correct answer is D: 'B and C.' Venlafaxine, a medication used to treat depression, can lead to adverse effects like dizziness and decreased libido. It is important for the nurse to monitor the client for these potential side effects. Cough and alopecia are not typically associated with Venlafaxine. Therefore, choices A (Cough) and C (Decreased libido) are incorrect. Dizziness and decreased libido are the adverse effects that the nurse should focus on when monitoring a client on Venlafaxine treatment.

2. A client has a prescription for Desmopressin for the treatment of Diabetes Insipidus. Which of the following instructions should the nurse include in the teaching?

• A. Decrease fluid intake at the start of treatment.
• B. Monitor for nocturia.
• C. Report a weight loss of 0.5 kg (1.1 lb) per week.
• D. Expect permanent polyuria with this medication.

Correct answer: A

Rationale: Desmopressin is a medication used to reduce diuresis in clients with diabetes insipidus. To prevent water intoxication, clients should be advised to decrease fluid intake at the beginning of treatment. This instruction helps to balance fluid levels in the body and prevent potential complications associated with excessive fluid intake while on Desmopressin therapy. Monitoring for signs of fluid retention, such as weight gain, and adjusting fluid intake accordingly are essential components of client education when initiating treatment with Desmopressin.

3. A client is starting therapy with Atenolol. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypertension

Correct answer: C

Rationale: Atenolol is a beta-blocker that can cause bradycardia as an adverse effect due to its mechanism of action in slowing down the heart rate. The nurse should instruct the client to monitor their pulse regularly and report any significant decreases to prevent complications related to bradycardia.

4. Which of the following is a potassium-sparing diuretic?

• A. Furosemide
• B. Spironolactone
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: B

Rationale: Spironolactone is classified as a potassium-sparing diuretic. It works by antagonizing the aldosterone receptor, leading to potassium retention and sodium excretion. This mechanism makes it a suitable choice for conditions where potassium retention is desired, such as in patients with heart failure or liver cirrhosis. Choices A, C, and D are not potassium-sparing diuretics. Furosemide, hydrochlorothiazide, and bumetanide are loop diuretics and thiazide diuretics, respectively, which promote the excretion of potassium.

5. A client is taking metformin for type 2 diabetes. Which of the following findings should indicate to the nurse that the medication is effective?

• A. Increased urine output
• B. Decreased fasting blood glucose
• C. Decreased hemoglobin A1C
• D. Decreased polyuria

Correct answer: C

Rationale: A decrease in hemoglobin A1C is a more specific indicator of metformin's effectiveness in controlling blood glucose levels over a longer period compared to fasting blood glucose levels. Hemoglobin A1C reflects average blood sugar levels over the past 2-3 months, providing a more comprehensive view of glycemic control. Increased urine output (choice A) is not a direct indicator of metformin's effectiveness and can be influenced by various factors. Decreased fasting blood glucose (choice B) can fluctuate due to various reasons and may not provide a reliable long-term assessment of metformin's efficacy. Decreased polyuria (choice D) refers to a symptom rather than a direct measure of metformin's effectiveness in managing diabetes.

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