Nursing Elites

1. A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?

• A. Irregular heart rhythm
• B. Abnormal uterine bleeding
• C. Yellowing of the sclera or dark-colored urine
• D. Difficulty swallowing

Correct answer: B

Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.

2. When reviewing a client's health record, a healthcare professional notes that the client is experiencing episodes of hypokalemia. Which of the following medications should be identified as a cause of the client's hypokalemia?

• A. Captopril
• B. Lisinopril
• C. Furosemide
• D. Spironolactone

Correct answer: C

Rationale: Furosemide, a loop diuretic, can lead to hypokalemia by increasing the excretion of potassium in the urine. This potassium loss can result in lower-than-normal levels of potassium in the body, leading to hypokalemia.

3. A client with osteoporosis has a new prescription for alendronate. Which of the following instructions should the nurse provide?

• A. Take the medication with a meal.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Take the medication with a glass of juice.
• D. Take the medication with milk or food.

Correct answer: B

Rationale: The correct instruction for a client taking alendronate is to remain upright for at least 30 minutes after administration. This is essential to prevent esophageal irritation and ensure the medication reaches the stomach properly. Remaining upright reduces the risk of side effects such as esophagitis. Choices A, C, and D are incorrect as alendronate should not be taken with a meal, juice, milk, or food to optimize its absorption and effectiveness.

4. What is a severe adverse effect of warfarin?

• A. Bleeding
• B. Arrhythmias
• C. Blurred vision
• D. Bradycardia

Correct answer: A

Rationale: A severe adverse effect of warfarin is bleeding. Warfarin is an anticoagulant medication that works by inhibiting blood clotting factors, which can lead to an increased risk of bleeding. Excessive bleeding can occur internally or externally, and it is crucial for individuals taking warfarin to be aware of this potential complication and seek medical attention if they experience any signs of bleeding. Arrhythmias, blurred vision, and bradycardia are not typically associated with warfarin use, making them incorrect choices.

5. A client with heart failure is prescribed digoxin. Which statement by the client indicates an adverse effect of the medication?

• A. I can walk a mile a day.
• B. I've had a backache for several days.
• C. I am urinating more frequently.
• D. I feel nauseated and have no appetite.

Correct answer: D

Rationale: Nausea and loss of appetite are common early signs of digoxin toxicity, indicating an adverse effect of the medication. These symptoms should be reported to the healthcare provider immediately for further evaluation and management.

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