Nursing Elites

1. Disulfiram is taken by a client daily for abstinence maintenance. What is an adverse effect of this therapy?

• A. Hepatotoxicity
• B. Wernicke's aphasia
• C. Suicidal ideations
• D. Diarrhea

Correct answer: A

Rationale: The correct answer is A: Hepatotoxicity. Disulfiram is known to cause hepatotoxicity as a severe adverse effect. This occurs due to the inhibition of aldehyde dehydrogenase, leading to the accumulation of acetaldehyde when alcohol is consumed. Wernicke's aphasia (Choice B) is a language disorder unrelated to disulfiram therapy. Suicidal ideations (Choice C) may be associated with certain medications, but it is not a common adverse effect of disulfiram. Diarrhea (Choice D) is not a typical adverse effect of disulfiram.

2. A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?

• A. Osteoporosis
• B. Hypertension
• C. Peptic ulcer disease
• D. Immunosuppression

Correct answer: C

Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.

3. When administering amlodipine to a client with hypertension, what adverse effect should the nurse monitor for?

• A. Constipation
• B. Facial flushing
• C. Hypotension
• D. Jaundice

Correct answer: C

Rationale: The correct answer is C, Hypotension. Amlodipine is a calcium channel blocker commonly used to treat hypertension. One of the main adverse effects of amlodipine is hypotension, leading to low blood pressure. The nurse should monitor the client for signs of hypotension such as dizziness, lightheadedness, or fainting. Choices A, B, and D are incorrect because constipation, facial flushing, and jaundice are not typically associated with amlodipine administration.

4. A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site?

• A. a 45-degree angle
• B. a 60-degree angle
• C. a 75-degree angle
• D. a 90-degree angle

Correct answer: D

Rationale: Intramuscular injections in the ventrogluteal site should be administered at a 90-degree angle. This angle ensures that the medication reaches the muscle tissue effectively. Angles less than 90 degrees can cause subcutaneous injection instead of intramuscular, leading to slower absorption of the medication. Angles greater than 90 degrees risk hitting bone or nerves, causing unnecessary pain or injury. Therefore, the correct angle for administering intramuscular injections in the ventrogluteal site is 90 degrees.

5. A nurse is providing client education on how to administer insulin. Which of the following instructions should the nurse include?

• A. Administer the insulin into the deltoid muscle
• B. Rotate injection sites to prevent lipodystrophy
• C. Massage the site after injection
• D. Use the same site for each injection

Correct answer: B

Rationale: The correct instruction for administering insulin is to rotate injection sites to prevent lipodystrophy, a common complication of insulin therapy. Injecting into the deltoid muscle (Choice A) is not recommended for insulin injections. Massaging the site after injection (Choice C) is not necessary and can potentially increase the risk of lipodystrophy. Using the same site for each injection (Choice D) can lead to localized tissue damage and absorption irregularities, making it an incorrect choice.

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