Nursing Elites

1. A client has a new prescription for amlodipine. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor blood pressure daily.
• C. Increase intake of potassium-rich foods.
• D. Avoid consuming grapefruit juice.

Correct answer: B

Rationale: The correct answer is B: 'Monitor blood pressure daily.' When a client is prescribed amlodipine, it is essential to monitor their blood pressure regularly. Amlodipine is known to cause hypotension, so monitoring blood pressure helps ensure it stays within the desired range to prevent complications associated with low blood pressure. Choice A is incorrect because amlodipine can be taken with or without food. Choice C is incorrect as increasing potassium intake is not a specific instruction related to amlodipine. Choice D is incorrect as grapefruit juice interactions are not typically a concern with amlodipine.

2. A nurse is assessing a client who has a new prescription for albuterol. Which of the following findings should the nurse report to the provider?

• A. Dry mouth
• B. Tachycardia
• C. Weight gain
• D. Drowsiness

Correct answer: B

Rationale: The correct answer is B: Tachycardia. Albuterol is a bronchodilator medication commonly used to treat respiratory conditions such as asthma. Tachycardia, an increased heart rate, can be a potential side effect of albuterol, indicating excessive stimulation of the beta receptors. This side effect should be reported to the healthcare provider promptly to assess the need for further intervention or adjustment of the treatment plan. Choices A, C, and D are incorrect because dry mouth, weight gain, and drowsiness are not typically associated with albuterol use and are less likely to require immediate reporting compared to tachycardia.

3. A client is admitted to the hospital with a venous stasis leg ulcer. The nurse inspects the ulcer expecting to note which observation?

• A. The ulcer has a pale-colored base.
• B. The ulcer is deep, with even edges.
• C. The ulcer has little granulation tissue.
• D. The ulcer has a brownish or 'brawny' appearance.

Correct answer: D

Rationale: When assessing a venous stasis leg ulcer, the nurse should expect to note a brownish or 'brawny' appearance. This discoloration is often due to hemosiderin deposits. The correct answer is not A because venous stasis ulcers typically do not have a pale-colored base. Choice B is incorrect as venous stasis ulcers usually have irregular, shallow edges, not deep and even edges. Choice C is incorrect as venous stasis ulcers often have excess granulation tissue, not little granulation tissue. Recognizing the brownish or 'brawny' appearance is crucial for accurate diagnosis and appropriate treatment of venous stasis leg ulcers.

4. The LPN/LVN is assisting in the care of a client who has been prescribed enoxaparin (Lovenox) for the prevention of deep vein thrombosis (DVT). Which instruction should the nurse reinforce with the client?

• A. Avoid consuming foods high in vitamin K while taking this medication.
• B. Administer the injection in the same site each time for consistency.
• C. Report any unusual bleeding or bruising to your healthcare provider.
• D. Do not take aspirin if you experience any mild pain or discomfort.

Correct answer: C

Rationale: The correct instruction for the nurse to reinforce with the client is to report any unusual bleeding or bruising to their healthcare provider. This is crucial because unusual bleeding or bruising may indicate excessive anticoagulation, a potential side effect of enoxaparin. Prompt reporting to a healthcare provider is necessary to prevent complications. Choices A, B, and D are incorrect. Choice A is not directly related to enoxaparin and vitamin K interactions. Choice B is incorrect as rotating injection sites is essential for preventing tissue damage and irritation. Choice D is also incorrect as aspirin can increase the risk of bleeding when taken with enoxaparin.

5. A client is receiving morphine for pain. Which of the following assessments is the priority?

• A. Urine output
• B. Pupil reaction
• C. Respiratory rate
• D. Bowel sounds

Correct answer: C

Rationale: The correct answer is C: Respiratory rate. Monitoring the respiratory rate is the priority assessment for a client receiving morphine due to the risk of respiratory depression. Morphine is a potent opioid that can cause respiratory depression, which is a serious adverse effect that can be life-threatening. Assessing the client's respiratory rate is crucial to detect any signs of respiratory depression early and intervene promptly. Assessing urine output is important but not as critical as monitoring for respiratory depression with morphine. Pupil reaction and bowel sounds are also important assessments but do not take precedence over monitoring the respiratory rate when a client is on morphine.

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