Nursing Elites

1. A client with rheumatoid arthritis is prescribed long-term prednisone therapy. What adverse effect should the client monitor for according to the nurse's instruction?

• A. Stress fractures
• B. Orthostatic hypotension
• C. Gingival ulcerations
• D. Weight loss

Correct answer: A

Rationale: The correct answer is A: Stress fractures. Long-term prednisone therapy can lead to osteoporosis, which increases the risk of stress fractures. Option B, orthostatic hypotension, is not a common adverse effect associated with prednisone use. Option C, gingival ulcerations, is more commonly associated with conditions like periodontal disease or poor oral hygiene rather than prednisone therapy. Option D, weight loss, is not a typical adverse effect of prednisone; in fact, weight gain is more common due to prednisone's impact on metabolism.

2. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

• A. Hearing examination
• B. Glucose tolerance test
• C. Electrocardiogram
• D. Pulmonary function tests

Correct answer: C

Rationale: The correct answer is C: Electrocardiogram. Amitriptyline can cause cardiac arrhythmias, so an electrocardiogram is necessary before starting treatment. A hearing examination (choice A) is not required before initiating amitriptyline. A glucose tolerance test (choice B) is not indicated for starting this medication. Pulmonary function tests (choice D) are not necessary before initiating amitriptyline for depression.

3. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?

• A. Urine specific gravity of 1.035
• B. Urine specific gravity of 444
• C. Urine specific gravity of 2000
• D. Urine specific gravity of 1111.1

Correct answer: A

Rationale: A urine specific gravity greater than 1.030 indicates dehydration. In this case, a urine specific gravity of 1.035 suggests concentrated urine, indicating dehydration. Choices B, C, and D have values that are not within the normal range for urine specific gravity and do not indicate dehydration. A urine specific gravity of 444, 2000, or 1111.1 are not physiologically possible values and are therefore incorrect.

4. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include that a severe allergy to which of the following medications is a contraindication to ceftriaxone?

• A. Gentamicin
• B. Clindamycin
• C. Piperacillin
• D. Sulfamethoxazole-trimethoprim

Correct answer: C

Rationale: The correct answer is C. Ceftriaxone, a cephalosporin antibiotic, has a cross-sensitivity with penicillin antibiotics like piperacillin. Therefore, a severe allergy to penicillin or penicillin-related antibiotics would be a contraindication to ceftriaxone. Choices A, B, and D are incorrect because they are not associated with a known cross-sensitivity with ceftriaxone.

5. A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?

• A. Raynaud's phenomenon
• B. Migraine headaches
• C. Ulcerative colitis
• D. Anemia

Correct answer: B

Rationale: Ergotamine is used to treat migraine headaches by constricting blood vessels in the brain. Therefore, the correct answer is B. Choice A, Raynaud's phenomenon, is incorrect as ergotamine is not indicated for this condition. Choice C, Ulcerative colitis, is incorrect as ergotamine is not used to treat this gastrointestinal disorder. Choice D, Anemia, is incorrect as ergotamine is not prescribed for anemia.

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