Nursing Elites

1. 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.

2. A client with a new prescription for Escitalopram for the treatment of generalized anxiety disorder is being taught by a healthcare provider. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication on an empty stomach.
• B. I will follow a low-sodium diet while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I should not crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. This gradual reduction helps minimize potential withdrawal symptoms and ensures a safer discontinuation process. Choices A, B, and D are incorrect because taking escitalopram on an empty stomach, following a low-sodium diet, and not crushing the medication are not directly related to the safe and effective use of the medication or its discontinuation process.

3. What should you assess for in a patient who is on Valproate?

• A. Suicidal thoughts
• B. Monitor for seizures
• C. Bipolar disorder
• D. Migraines

Correct answer: A

Rationale: The correct answer is A: Suicidal thoughts. When a patient is prescribed Valproate, it is crucial to assess for suicidal thoughts as it is a serious side effect associated with this medication. Valproate has been linked to an increased risk of suicidal ideation and behavior, particularly in patients with epilepsy or bipolar disorder. Monitoring for signs of depression or changes in behavior is essential to ensure patient safety and well-being. Choices B, C, and D are incorrect because while monitoring for seizures, managing bipolar disorder, and treating migraines are also important considerations when a patient is on Valproate, assessing for suicidal thoughts takes priority due to the serious nature of this potential side effect.

4. A client with peptic ulcer disease is prescribed omeprazole. Which finding should indicate to the nurse that the medication is effective?

• A. Relief of headache
• B. Relief of nausea
• C. Relief of abdominal pain
• D. Relief of heartburn

Correct answer: C

Rationale: Relief of abdominal pain is a key indicator of omeprazole effectively treating peptic ulcer disease. Omeprazole works by reducing stomach acid production, which helps alleviate abdominal pain associated with peptic ulcers. While relief of other symptoms like headache, nausea, and heartburn may also occur, the primary therapeutic goal of omeprazole in peptic ulcer disease is to reduce abdominal pain caused by gastric irritation. Therefore, the relief of abdominal pain is the most significant finding to indicate the effectiveness of omeprazole in this context. Choices A, B, and D may improve as a result of decreased stomach acid production, but they are not as specific or central to the therapeutic goal of treating peptic ulcer disease as the relief of abdominal pain.

5. 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.

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