Nursing Elites

1. When teaching the parents of a child who has a new prescription for Desipramine, which of the following adverse effects should the nurse instruct the parents is the priority to report to the provider?

• A. Constipation
• B. Suicidal thoughts
• C. Photophobia
• D. Dry mouth

Correct answer: B

Rationale: The priority adverse effect to report when a child is taking Desipramine is suicidal thoughts. Desipramine can lead to an increased risk of suicidal thoughts and behaviors. The nurse should emphasize to the parents the importance of monitoring the child for any signs of worsening depression or suicidal ideation. Prompt reporting of such symptoms can help prevent harm to the child. Choices A, C, and D are not the priority adverse effects associated with Desipramine. While constipation, photophobia, and dry mouth can occur as side effects of Desipramine, they are not as critical as the risk of suicidal thoughts, which requires immediate attention to ensure the safety of the child.

2. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

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

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct instruction for a client prescribed Lisinopril is to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, hence the importance of avoiding salt substitutes that may contain potassium. Instructing the client to avoid salt substitutes helps prevent potential adverse effects of increased potassium levels.

4. A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Dry mouth
• C. Insomnia
• D. Hypertension

Correct answer: B

Rationale: Dry mouth is a common adverse effect associated with Clonidine use. Clonidine is known to cause a reduction in saliva production, leading to dry mouth. Monitoring for this adverse effect is essential to ensure client comfort and compliance with the medication. Diarrhea is not a common adverse effect of Clonidine. Insomnia is more commonly associated with opioid withdrawal rather than Clonidine use. While Clonidine is used to treat hypertension, it is not typically an adverse effect of the medication.

5. A client with prostate cancer is receiving leuprolide. Which of the following findings should the nurse monitor?

• A. Increased testosterone levels
• B. Increased libido
• C. Gynecomastia
• D. Hypoglycemia

Correct answer: C

Rationale: The nurse should monitor the client for gynecomastia when receiving leuprolide as it can cause decreased testosterone levels, leading to the development of gynecomastia. Choices A, B, and D are incorrect because leuprolide actually decreases testosterone levels, which would not result in increased testosterone levels or libido. Leuprolide is not associated with hypoglycemia, so monitoring for this is unnecessary in a client receiving this medication.

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