Nursing Elites

1. A client is being taught by a nurse about long-term use of oral prednisone for chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Weight Gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is a common adverse effect of long-term prednisone use. Prednisone, a corticosteroid medication, can cause fluid retention and increased appetite, leading to weight gain. Nervousness (choice B) is more commonly associated with stimulant medications or excessive caffeine intake. Bradycardia (choice C) refers to a slow heart rate and is not a typical adverse effect of prednisone. Constipation (choice D) is not a common side effect of prednisone; in fact, prednisone is more likely to cause gastrointestinal issues such as increased appetite and weight gain.

2. Which of the following is not directly related to the drug toxicity of Ibuprofen?

• A. Nausea
• B. Renal dysfunction
• C. Anemia
• D. Muscle wasting

Correct answer: D

Rationale: Ibuprofen is known to cause adverse effects such as nausea, renal dysfunction, and anemia. However, muscle wasting is not a common toxicity associated with Ibuprofen use. Therefore, the correct answer is D.

3. While assessing a client taking Amiodarone to treat Atrial Fibrillation, which of the following findings is indicative of Amiodarone toxicity?

• A. Light yellow urine
• B. Report of tinnitus
• C. Productive cough
• D. Blue-gray skin discoloration

Correct answer: C

Rationale: Productive cough can indicate pulmonary toxicity, which is a known adverse effect of Amiodarone. Clients on Amiodarone should be monitored for signs of pulmonary toxicity such as cough, dyspnea, and chest pain. This is important to detect early and prevent serious complications. The other options are not typically associated with Amiodarone toxicity. Light yellow urine is not a common sign, tinnitus is more related to ear problems, and blue-gray skin discoloration is not a recognized symptom of Amiodarone toxicity.

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

• A. Take this medication before bed.
• B. Take the medication with food.
• C. Sit upright for at least 30 minutes after taking the medication.
• D. Expect to have frequent headaches while on this medication.

Correct answer: C

Rationale: The correct instruction for a client prescribed Alendronate is to sit upright for at least 30 minutes after taking the medication. Alendronate can cause esophageal irritation, and maintaining an upright position helps prevent this adverse effect by reducing the risk of reflux of the medication into the esophagus. Choice A is incorrect because Alendronate should be taken in the morning, at least 30 minutes before the first food, beverage, or medication of the day with a full glass of plain water. Choice B is incorrect because Alendronate should not be taken with food. Choice D is incorrect because frequent headaches are not a common side effect of Alendronate.

5. A healthcare provider in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings are indicative of this condition?

• A. Insidious onset of painless loss of vision
• B. Gradual reduction in peripheral vision
• C. Severe pain around the eyes
• D. Intraocular pressure of 12mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a characteristic symptom of acute angle-closure glaucoma. This intense pain is typically accompanied by other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. The acute rise in intraocular pressure leads to these symptoms, indicating a medical emergency that requires immediate attention to prevent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more suggestive of conditions like age-related macular degeneration or diabetic retinopathy. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12mm Hg is within the normal range and not indicative of the acute rise seen in angle-closure glaucoma.

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