Nursing Elites

1. A client is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion?

• A. I signed up for a swimming class.
• B. I've been taking an antacid to help with indigestion.
• C. I've lost 2 pounds since my appointment 2 weeks ago.
• D. The naproxen is easier to take when I crush it and put it in applesauce.

Correct answer: B

Rationale: The client stating that they have been taking an antacid to help with indigestion while on naproxen requires further discussion. This statement suggests potential gastrointestinal distress or interactions between the medications. Antacids can affect the absorption of naproxen or lead to other complications. Therefore, the nurse should address this statement with the client to ensure safe and effective medication management. Choices A, C, and D do not raise immediate concerns related to the client's medication regimen and can be considered positive health behaviors or side effects of treatment that do not require immediate intervention.

2. A client is starting therapy with Metformin. Which of the following instructions should the nurse include?

• A. Take this medication with your first bite of food.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. Instructing the client to take the medication with the first bite of food helps in achieving optimal effectiveness and minimizes the risk of side effects like nausea or upset stomach. Choice B is incorrect because taking Metformin on an empty stomach can lead to increased gastrointestinal side effects. Choice C is incorrect as there is no specific timing requirement for taking Metformin before bedtime. Choice D is incorrect as Metformin is usually taken daily, not every other day.

3. A client is taking Propylthiouracil. For which of the following adverse effects of this medication should the nurse monitor?

• A. Bradycardia
• B. Insomnia
• C. Heat intolerance
• D. Weight loss

Correct answer: A

Rationale: Propylthiouracil is a medication used to treat hyperthyroidism. One of the adverse effects of Propylthiouracil is bradycardia, which is a slower than normal heart rate. Since the medication works by decreasing thyroid hormone production, it can lead to hypothyroidism as a side effect, causing bradycardia. Therefore, the nurse should monitor the client for signs and symptoms of bradycardia while taking Propylthiouracil. Choices B, C, and D are incorrect because insomnia, heat intolerance, and weight loss are not typically associated adverse effects of Propylthiouracil.

4. A client has a new prescription for Levothyroxine to treat hypothyroidism. Which of the following instructions should be included in the teaching?

• A. Take this medication with food.
• B. Take this medication at bedtime.
• C. Expect to see results in 1 week.
• D. Do not discontinue the medication without consulting the provider.

Correct answer: D

Rationale: The correct instruction for a client with a new prescription for Levothyroxine to treat hypothyroidism is not to discontinue the medication without consulting the provider. Abrupt cessation could lead to the return of hypothyroid symptoms, emphasizing the importance of medical guidance when considering any changes to the treatment plan. Choice A is incorrect because Levothyroxine should be taken on an empty stomach, typically in the morning. Choice B is incorrect as it contradicts the timing of administration for Levothyroxine. Choice C is inaccurate as it usually takes a few weeks for the full effects of Levothyroxine to be seen, not just 1 week.

5. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: The correct answer is B: Fever. Fever is a key symptom of serotonin syndrome, a potentially life-threatening condition that can occur with the use of serotonergic medications like Sertraline. Serotonin syndrome is characterized by a combination of symptoms, including fever, agitation, rapid heartbeat, sweating, shivering, tremors, and in severe cases, it can lead to seizures, coma, and even death. Bruising (Choice A), abdominal pain (Choice C), and rash (Choice D) are not typically associated with serotonin syndrome. Therefore, the nurse should be vigilant in monitoring for fever as an early sign of serotonin syndrome in clients taking Sertraline.

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