Nursing Elites

1. A client is receiving chemotherapy and has a prescription for ondansetron IV for nausea and vomiting. The nurse should monitor the client for which of the following adverse effects?

• A. Hypotension
• B. Bradycardia
• C. Tremors
• D. Urinary retention

Correct answer: C

Rationale: The correct answer is C: Tremors. Ondansetron can cause tremors as an adverse effect. Monitoring for tremors is essential as it can indicate a potential adverse reaction to the medication. Hypotension (choice A) and bradycardia (choice B) are not commonly associated with ondansetron. Urinary retention (choice D) is also not a typical adverse effect of ondansetron, making choices A, B, and D incorrect in this scenario.

2. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

• A. It can take several weeks before you feel like the medication is helping.
• B. Take the medication just before bedtime to promote sleep.
• C. You should take the medication when needed for obsessive urges.
• D. Monitor for weight gain while taking this medication.

Correct answer: A

Rationale: The correct instruction for the nurse to include when teaching a client with OCD who has a new prescription for Paroxetine is that it can take several weeks before the client feels like the medication is helping. Paroxetine, like other selective serotonin reuptake inhibitors (SSRIs), can take 1 to 4 weeks before the client reaches the full therapeutic benefit. Therefore, it is important to inform the client about this delay in onset of action to manage their expectations and promote adherence to the treatment plan. Choices B, C, and D are incorrect because taking Paroxetine before bedtime is not necessary, it should be taken consistently at the same time each day; Paroxetine is usually taken regularly, not as needed; and while monitoring weight is important, it is not a specific instruction related to the onset of action for Paroxetine.

3. A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)

• A. Expect therapeutic effects in 1-3 weeks.
• B. Discontinue the medication gradually under healthcare provider supervision.
• C. Change positions slowly to minimize dizziness.
• D. Increase dietary fiber intake to prevent constipation.

Correct answer: C

Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. The therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so increasing dietary fiber intake would be recommended to prevent constipation, making choice D incorrect.

4. A client is taking Warfarin for atrial fibrillation. Which of the following client statements indicates a need for further teaching?

• A. I will avoid eating broccoli.
• B. I will use an electric razor to shave.
• C. I will take aspirin for headaches.
• D. I will have my blood tested regularly.

Correct answer: C

Rationale: The correct answer is C. Taking aspirin along with Warfarin can increase the risk of bleeding. Clients should be advised to avoid medications that increase the risk of bleeding when taking Warfarin to prevent complications. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding foods high in Vitamin K, using an electric razor to prevent cuts that can lead to bleeding, and regular blood testing to monitor Warfarin levels are all important aspects of managing Warfarin therapy.

5. Potassium-sparing diuretics primarily affect which part of the kidney?

• A. Proximal convoluted tubule
• B. Loop of Henle
• C. Collecting duct
• D. Distal convoluted tubule

Correct answer: D

Rationale: Potassium-sparing diuretics exert their primary effects on the distal convoluted tubule in the kidney. By acting on this specific part of the nephron, these diuretics promote sodium excretion while sparing potassium, thus helping to maintain potassium levels in the body. This mechanism differs from other diuretics that may cause potassium loss as a side effect. Understanding the site of action of potassium-sparing diuretics is crucial in clinical practice for managing conditions like hypertension and edema where diuresis is necessary without the risk of hypokalemia.

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