Nursing Elites

1. 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.

2. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: Corrected Question: When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor? Amitriptyline is known to cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down or sitting to a standing position. Monitoring for orthostatic hypotension is crucial to prevent falls and related injuries. Educating the client about moving slowly and changing positions gradually can help mitigate this adverse effect. Choices A, B, and C are incorrect because decreased appetite, explosive diarrhea, and decreased pulse rate are not commonly associated with Amitriptyline use. Therefore, the correct answer is D.

3. When educating a client who has a new prescription for Hydrochlorothiazide, which of the following statements should the nurse include?

• A. Take this medication in the morning.
• B. You may need to increase your intake of potassium.
• C. This medication may cause drowsiness.
• D. Avoid consuming grapefruit.

Correct answer: B

Rationale: The correct statement to include when educating a client with a new prescription for Hydrochlorothiazide is that they may need to increase their intake of potassium. Hydrochlorothiazide is a thiazide diuretic that can lead to potassium loss. Monitoring potassium levels and increasing potassium intake if necessary can help prevent complications associated with hypokalemia. Option A is not directly related to the medication's specific instructions. Option C is incorrect as Hydrochlorothiazide typically does not cause drowsiness. Option D is unrelated, as there is no interaction between Hydrochlorothiazide and grapefruit.

4. A client has a prescription for Heparin. Which of the following laboratory tests should be monitored while the client is receiving Heparin?

• A. Prothrombin time (PT)
• B. Complete blood count (CBC)
• C. International normalized ratio (INR)
• D. Activated partial thromboplastin time (aPTT)

Correct answer: D

Rationale: Activated partial thromboplastin time (aPTT) is the correct laboratory test to monitor while a client is receiving Heparin. This test is used to assess the therapeutic levels of heparin in the blood, ensuring that the dose is within the safe and effective range. Monitoring aPTT helps healthcare providers adjust the dosage of Heparin to prevent complications such as bleeding or clotting.

5. A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.

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