Nursing Elites

1. A client has a new prescription for clonidine to treat hypertension. Which of the following instructions should the nurse include?

• A. Discontinue the medication if a rash develops.
• B. Expect increased salivation during the first few weeks of therapy.
• C. Avoid driving until the client's reaction to the medication is known.
• D. Stop the medication if you experience a dry mouth.

Correct answer: C

Rationale: The correct instruction for a client starting clonidine therapy for hypertension is to avoid driving until their reaction to the medication is known. Clonidine can cause drowsiness, so it is important for the client to refrain from activities that require alertness until they are aware of how the medication affects them. Choice A is incorrect because a rash is not a common side effect of clonidine. Choice B is incorrect as increased salivation is not an expected side effect of clonidine. Choice D is also incorrect as dry mouth is a common side effect of clonidine, but it is not a reason to stop the medication unless severe or bothersome. Therefore, the priority instruction for the nurse to include is to advise the client to avoid driving until their reaction to the medication is known to ensure safety.

2. A healthcare professional is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare professional should monitor the client for which of the following as an adverse effect of this medication?

• A. Bradycardia
• B. Hyperkalemia
• C. Hypoglycemia
• D. Hypocalcemia

Correct answer: B

Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, which leads to potassium retention. Monitoring potassium levels is essential to prevent potential complications associated with hyperkalemia. The other options, bradycardia, hypoglycemia, and hypocalcemia, are not typically associated with Enalapril use and are less likely to occur as adverse effects.

3. A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the client should be advised to do which of the following?

• A. Avoid using acetaminophen for headaches.
• B. Restrict intake of foods rich in sodium.
• C. Decrease fluid intake to less than 1,500 mL daily.
• D. Limit aerobic activity in hot weather.

Correct answer: D

Rationale: The correct answer is to advise the client to limit aerobic activity in hot weather. Aerobic activity in hot weather can lead to excessive sweating, potentially causing sodium and water depletion, which can increase the risk of Lithium toxicity. It is important for clients taking Lithium to maintain adequate hydration and sodium levels to prevent toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting intake of foods rich in sodium is not recommended because adequate sodium levels are necessary to prevent Lithium toxicity. Decreasing fluid intake to less than 1,500 mL daily is also not advisable as adequate hydration is important to prevent Lithium toxicity.

4. A healthcare professional is providing discharge instructions to a client who has a new prescription for Enoxaparin. Which of the following instructions should the healthcare professional include?

• A. Inject the medication into the muscle.
• B. Massage the injection site after administration.
• C. Rotate injection sites between the arms and thighs.
• D. Administer the medication in the abdomen.

Correct answer: D

Rationale: The correct instruction is to administer Enoxaparin in the abdomen as a subcutaneous injection. This method helps prevent bleeding complications associated with the medication. Massaging the injection site after administration should be avoided to reduce the risk of local irritation or bleeding. While rotating injection sites between the arms and thighs is a good practice for some medications, it is not recommended for Enoxaparin. Consistent administration in the abdomen ensures optimal absorption and helps avoid complications.

5. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously for Rheumatoid Arthritis. Injection-site reactions such as redness and swelling are common. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for potential adverse effects.

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