Nursing Elites

1. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.

2. A client has a new prescription for Cyanocobalamin (Vitamin B12) injections. Which of the following client statements indicates an understanding of the teaching?

• A. I will need to take this medication for the rest of my life.
• B. I will stop taking the medication when my symptoms improve.
• C. I should take this medication with food.
• D. I will need to avoid green, leafy vegetables while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Clients with pernicious anemia or other causes of vitamin B12 deficiency may need to take cyanocobalamin for life to prevent deficiency. It is a lifelong treatment in many cases to maintain adequate B12 levels. Choice B is incorrect because stopping the medication when symptoms improve may lead to a relapse of the deficiency. Choice C is incorrect as cyanocobalamin injections are usually administered on an empty stomach. Choice D is incorrect as there is no need to avoid green, leafy vegetables while taking cyanocobalamin; in fact, these vegetables are good dietary sources of vitamin B12.

3. A client has a new prescription for Hydralazine. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hyperglycemia
• C. Hyponatremia
• D. Constipation

Correct answer: A

Rationale: Corrected Rationale: Hydralazine is a vasodilator that can cause reflex tachycardia as an adverse effect. The client should monitor their pulse and report any significant increases, as tachycardia can indicate a severe adverse reaction to the medication. Choice B, Hyperglycemia, is not a common adverse effect of Hydralazine. Choice C, Hyponatremia, and Choice D, Constipation, are also not typically associated with Hydralazine use. Therefore, the correct answer is A: Tachycardia.

4. A client has a new prescription for Nitroglycerin to treat angina. Which of the following instructions should be included?

• A. Take this medication only when experiencing chest pain.
• B. Store the medication in a cool, dry place.
• C. Apply the patch to a different site each time.
• D. Do not cut the patch regardless of your blood pressure.

Correct answer: C

Rationale: When using Nitroglycerin patches to treat angina, it is crucial to apply the patch to a different site each time. This practice helps prevent skin irritation and ensures proper absorption of the medication, optimizing its effectiveness in managing angina symptoms.

5. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client be instructed to monitor for and report to the provider?

• A. Dry cough
• B. Pedal edema
• C. Bruising
• D. Yellow-tinged vision

Correct answer: D

Rationale: Yellow-tinged vision is a potential adverse effect of digoxin, which may indicate toxicity. It is crucial for the client to report this symptom promptly to the healthcare provider to prevent any further complications. Dry cough is not typically associated with digoxin use. Pedal edema is a common symptom of heart failure, which digoxin is prescribed to manage. Bruising is not a common adverse effect of digoxin.

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