Nursing Elites

1. The healthcare provider has administered albuterol as an inhaled medication. The healthcare provider should monitor the client for which possible adverse reaction?

• A. Enuresis
• B. Lethargy
• C. Depression
• D. Tachycardia

Correct answer: D

Rationale: Albuterol is a bronchodilator in the adrenergic category. Its actions and adverse effects are similar to adrenaline or epinephrine. The healthcare provider should monitor the client for tachycardia, which is a common adverse effect of albuterol due to its stimulant effect on beta-2 receptors. Enuresis, or night bed-wetting, is not an adverse effect associated with albuterol. Additionally, the client should be monitored for anxiety as a potential adverse effect, not lethargy or depression, which are not typically associated with albuterol administration.

2. A client with chronic kidney disease is prescribed lanthanum carbonate. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: A

Rationale: Lanthanum carbonate is prescribed in chronic kidney disease to bind dietary phosphorus in the gastrointestinal tract. This action can lead to decreased phosphorus absorption and potential hypercalcemia due to the increased serum calcium levels. Therefore, the nurse should monitor the client for signs and symptoms of hypercalcemia, such as confusion, fatigue, and muscle weakness. Choices B, C, and D are incorrect as lanthanum carbonate's mechanism of action does not lead to hypocalcemia, hyperkalemia, or hypokalemia.

3. A client with a diagnosis of schizophrenia is prescribed risperidone. The nurse should monitor for which potential side effect?

• A. Weight gain
• B. Tremors
• C. Insomnia
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Weight gain. When a client is prescribed risperidone, monitoring weight is crucial due to the potential side effect of weight gain associated with this medication. This side effect can be significant as it may lead to other health issues. Choice B, Tremors, is not typically associated with risperidone use. Choice C, Insomnia, is less likely to be a direct side effect of risperidone compared to weight gain. Choice D, Hyperglycemia, is a possible side effect of some antipsychotic medications, but it is not commonly associated with risperidone.

4. What instructions should the PN reinforce with the client regarding the newly prescribed medications isosorbide dinitrate and hydrochlorothiazide?

• A. Instruct the client to use a soft bristle toothbrush.
• B. Instruct the client to slowly rise from a sitting or lying down position.
• C. Instruct the client to elevate their legs above the level of their heart.
• D. Instruct the client to limit the amount of fiber in their diet.

Correct answer: B

Rationale: The correct instruction for the client is to slowly rise from a sitting or lying down position. Isosorbide dinitrate, a nitrate, and hydrochlorothiazide, a diuretic, can both cause hypotension. When used together, their additive effects can further lower blood pressure, leading to orthostatic hypotension. Instructing the client to change positions slowly helps prevent a sudden drop in blood pressure, reducing the risk of dizziness or falls. Choices A, C, and D are incorrect because they do not directly address the potential side effect of hypotension associated with the prescribed medications. Using a soft bristle toothbrush, elevating legs above the heart level, or limiting fiber intake are not specific instructions to mitigate the risk of orthostatic hypotension.

5. A client with a history of chronic kidney disease is prescribed epoetin alfa. The nurse should monitor for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Hyperglycemia
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Epoetin alfa can lead to hypertension as an adverse effect because it stimulates increased red blood cell production. This can result in elevated blood pressure levels, requiring careful monitoring by the nurse to prevent complications. Choice B, hypotension, is incorrect because epoetin alfa is more likely to cause hypertension rather than hypotension. Choice C, hyperglycemia, and Choice D, tachycardia, are also incorrect as they are not commonly associated with the use of epoetin alfa.

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