Nursing Elites

1. A nurse is teaching a client who has a new prescription for Etanercept for Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will need to get my blood drawn periodically while on this medication.'
• B. I should stop taking this medication if I develop a rash.'
• C. I will need to limit my alcohol intake to no more than one drink per week.'
• D. I should self-administer this medication subcutaneously into the muscle.'

Correct answer: A

Rationale: Etanercept can cause bone marrow suppression, so it is important to monitor blood counts regularly.

2. A healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause a non-productive cough due to its effect on bradykinin levels. The client should be advised to report this symptom to their healthcare provider to consider alternative treatments. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not typically associated with Enalapril use.

3. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old who has no health problems
• B. 17-year-old who has a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. The nasal spray vaccine (LAIV) is a live attenuated vaccine that is suitable for healthy individuals aged 2-49 years. Pregnancy (choice C) is a contraindication for the nasal spray influenza vaccine. Children under 2 years of age (choice A) are also not candidates for the nasal spray. Taking a multivitamin supplement (choice D) is not a determining factor for the type of influenza vaccine a person should receive.

4. A client has a new prescription for Digoxin. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor your pulse before taking the medication.
• C. Expect to have an increased appetite.
• D. Discontinue the medication if you feel nauseated.

Correct answer: B

Rationale: When educating a client about Digoxin, it is crucial to instruct them to monitor their pulse before taking the medication. Digoxin can lead to bradycardia, so monitoring the pulse is essential to ensure it is not below 60 beats per minute before taking each dose. If the pulse is low, the client should hold the dose and seek guidance from their healthcare provider. Choices A, C, and D are incorrect. Taking Digoxin with food may affect its absorption, Digoxin is not known to increase appetite, and feeling nauseated does not necessarily indicate the need to discontinue the medication.

5. Hydrochlorothiazide is classified as a

• A. Anti-inflammatory
• B. Antiarrhythmic
• C. Diuretic
• D. Antifungal

Correct answer: C

Rationale: Hydrochlorothiazide is classified as a diuretic. Diuretics are medications that help the body get rid of excess salt and water by increasing urine production, reducing fluid retention, and lowering blood pressure. Option A, Anti-inflammatory, is incorrect because hydrochlorothiazide does not primarily reduce inflammation. Option B, Antiarrhythmic, is incorrect because hydrochlorothiazide is not used to correct heart rhythm irregularities. Option D, Antifungal, is incorrect because hydrochlorothiazide is not used to treat fungal infections.

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