Nursing Elites

1. A client is starting to take amitriptyline. The healthcare provider should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Urinary retention
• C. Bradycardia
• D. Dry cough

Correct answer: B

Rationale: The correct answer is B: Urinary retention. Amitriptyline, a tricyclic antidepressant, can cause relaxation of the bladder sphincter muscles, leading to urinary retention. Monitoring for urinary retention is crucial as it is a common anticholinergic effect associated with this medication. Diarrhea (choice A) is not a common adverse effect of amitriptyline. Bradycardia (choice C) is more commonly associated with beta-blockers rather than tricyclic antidepressants like amitriptyline. Dry cough (choice D) is not a typical adverse effect of amitriptyline.

2. A healthcare professional is preparing to administer furosemide 80 mg PO daily. The available furosemide oral solution is 10 mg/1 mL. How many mL should the healthcare professional administer?

• A. 8 mL
• B. 10 mL
• C. 6 mL
• D. 12 mL

Correct answer: A

Rationale: To determine the volume to administer, divide the desired dose by the available concentration. In this case, 80 mg divided by 10 mg/mL equals 8 mL. Therefore, the healthcare professional should administer 8 mL of furosemide oral solution. Choice B, 10 mL, is incorrect as it does not reflect the accurate calculation. Choices C and D, 6 mL and 12 mL respectively, are also incorrect as they do not match the correct calculation based on the provided concentration and dose.

3. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

4. A healthcare professional is educating a client who is beginning therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is dyspnea. Dyspnea can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Prompt reporting of dyspnea allows for timely evaluation and management to prevent potential complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings that the client should report.

5. When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Expect the development of a mild rash.
• B. Take the medication on an empty stomach.
• C. Monitor for signs of gingival hyperplasia.
• D. Increase your intake of calcium.

Correct answer: C

Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.

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