Nursing Elites

1. When assessing the effectiveness of leflunomide (Arava) in a client with rheumatoid arthritis, which question should the nurse ask during data collection?

• A. Do you have any joint pain?
• B. Are you having any diarrhea?
• C. Do you have frequent headaches?
• D. Are you experiencing heartburn?

Correct answer: A

Rationale: To assess the effectiveness of leflunomide (Arava), a medication used to treat rheumatoid arthritis, the nurse should inquire about joint pain. Joint pain is a common symptom of rheumatoid arthritis, and improvement in joint pain indicates the medication's effectiveness in managing the condition.

2. A client with heart failure is prescribed furosemide (Lasix) and digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?

• A. Avoid foods high in potassium.
• B. Report a pulse rate less than 60 beats per minute.
• C. Take the medications in the morning.
• D. Weigh yourself daily.

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to report a pulse rate less than 60 beats per minute, as it could indicate digoxin toxicity. Consuming potassium-rich foods is encouraged due to the potential for furosemide (Lasix) to cause hypokalemia. The medications should be taken in the morning to prevent nocturia. Weighing oneself daily is important to monitor for fluid retention, a crucial aspect in managing heart failure. Therefore, choices A, C, and D are incorrect as they do not address the specific teaching point related to digoxin and its potential toxicity.

3. Mafenide acetate (Sulfamylon) is prescribed for a client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?

• A. Notifying the registered nurse
• B. Discontinuing the medication
• C. Informing the client that this is normal
• D. Applying a thinner film than prescribed to the burn site

Correct answer: C

Rationale: The correct action is to inform the client that local discomfort and burning are normal reactions to Mafenide acetate. This medication is used to treat burns by reducing bacteria in avascular tissues. Discontinuing the medication or applying a thinner film than prescribed is not necessary or recommended in this situation.

4. A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication?

• A. Diarrhea
• B. Weakness
• C. Headache
• D. Constipation

Correct answer: D

Rationale: Constipation is a common side effect of iron supplements such as ferrous sulfate. Iron can cause constipation by slowing down the movement of the digestive system and hardening the stool. Patients should be advised to increase their fluid intake, dietary fiber, and physical activity to help alleviate this side effect. Diarrhea (Choice A) is not a common side effect associated with ferrous sulfate. Weakness (Choice B) and headache (Choice C) are not typically linked to this medication.

5. A client is prescribed amlodipine (Norvasc) for hypertension. Which side effect should the nurse instruct the client to report to the healthcare provider?

• A. Dizziness
• B. Constipation
• C. Peripheral edema
• D. Dry cough

Correct answer: C

Rationale: The correct answer is C, 'Peripheral edema.' Amlodipine (Norvasc) can cause peripheral edema, which is an accumulation of fluid in the extremities and should be reported to the healthcare provider. Dizziness and constipation are possible side effects of amlodipine but are generally less concerning. Dry cough is more commonly associated with ACE inhibitors, not calcium channel blockers like amlodipine.

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