Nursing Elites

1. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

• A. Platelet count
• B. Electrolyte levels
• C. Thyroid function
• D. Liver function

Correct answer: D

Rationale: The correct answer is D: Liver function. Gemfibrozil can lead to hepatotoxicity, making it crucial to monitor liver function tests. Monitoring platelet count (choice A) is not specifically indicated for gemfibrozil. Electrolyte levels (choice B) and thyroid function (choice C) are not directly affected by gemfibrozil, so they are not the primary laboratory tests to monitor in this case.

2. A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?

• A. Antiestrogenic
• B. Antimicrobial
• C. Androgenic
• D. Anti-inflammatory

Correct answer: A

Rationale: Tamoxifen is an antiestrogen medication used primarily in the treatment and prevention of breast cancer. It works by blocking the effects of estrogen in the breast tissue, thereby acting as an antiestrogenic agent. This makes choice A the correct answer. Choice B, antimicrobial, is incorrect as tamoxifen does not possess antimicrobial properties and is not used to treat infections. Choice C, androgenic, is incorrect as tamoxifen has antiestrogenic effects, not androgenic effects. Choice D, anti-inflammatory, is incorrect as tamoxifen's main therapeutic action is antiestrogenic rather than anti-inflammatory.

3. A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Ecchymosis
• B. Jaundice
• C. Hypotension
• D. Hypokalemia

Correct answer: C

Rationale: The correct answer is C: Hypotension. Enalapril, an ACE inhibitor, can lead to hypotension, especially after the first dose. Choices A, B, and D are incorrect because enalapril is not typically associated with ecchymosis, jaundice, or hypokalemia as common adverse effects. Therefore, the nurse should primarily monitor the client for signs of hypotension.

4. A client with congestive heart failure taking digoxin reports nausea and refuses to eat breakfast. Which action should the nurse take first?

• A. Encourage the client to eat the toast on the breakfast tray.
• B. Administer an antiemetic.
• C. Inform the client's provider.
• D. Check the client's apical pulse.

Correct answer: D

Rationale: The correct action for the nurse to take first is to check the client's apical pulse. Nausea can be a sign of digoxin toxicity, and one of the early signs of digoxin toxicity is changes in the pulse rate. By checking the client's apical pulse, the nurse can assess if the digoxin level is too high. Encouraging the client to eat or administering an antiemetic may not address the underlying issue of digoxin toxicity. While informing the provider is important, assessing the client's condition through checking the apical pulse should be the immediate priority.

5. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypotension
• C. Bleeding
• D. Constipation

Correct answer: C

Rationale: The correct answer is C: Bleeding. Clopidogrel is an antiplatelet medication that works by preventing platelets from sticking together and forming clots. Therefore, one of the main adverse effects of clopidogrel is an increased risk of bleeding. Insomnia (Choice A), hypotension (Choice B), and constipation (Choice D) are not commonly associated with clopidogrel use. Monitoring for signs of bleeding, such as easy bruising, petechiae, or prolonged bleeding from minor cuts, is crucial when a client is taking clopidogrel.

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