Nursing Elites

1. The practical nurse (PN) is obtaining the medical history of a client starting a new prescription for conjugated estrogens PO daily. Which medical condition is not treated by this medication?

• A. Menopausal symptoms
• B. Prostatic cancer
• C. Thromboembolic diseases
• D. Abnormal uterine bleeding

Correct answer: C

Rationale: Conjugated estrogens, such as Premarin, are not used in the treatment of thromboembolic diseases. These medications are contraindicated in conditions predisposing to thromboembolic diseases due to their association with an increased risk of thromboembolism, stroke, pulmonary embolism, and myocardial infarction. Choices A, B, and D are incorrect because conjugated estrogens are commonly prescribed for managing menopausal symptoms, abnormal uterine bleeding, and certain hormone-responsive cancers, but not for thromboembolic diseases.

2. The healthcare provider notes that a client has a new prescription for 20 mEq of potassium. The IV site is inflamed but not tender, and has a blood flashback. What action should the healthcare provider take?

• A. Obtain a liter of normal saline with 20 mEq of KCl
• B. Contact the healthcare provider to clarify the prescription
• C. Withhold the prescription medication until a new IV is started
• D. Fax the prescription to the pharmacy for immediate dispensing

Correct answer: B

Rationale: The healthcare provider should contact the prescriber to clarify the prescription because an inflamed IV site may indicate potential issues with administering the medication. It is important to ensure that the prescription is appropriate and safe for the client before proceeding with administration. Option A is incorrect because administering potassium through an inflamed IV site can lead to further complications. Option C is not the best course of action as clarifying the prescription first is essential. Option D is also incorrect as the focus should be on ensuring the safety of the client before dispensing the medication.

3. A client with diabetes mellitus type 2 is prescribed canagliflozin. The nurse should include which instruction in the client's teaching plan?

• A. Report any signs of urinary tract infection.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Avoid taking this medication with grapefruit juice.

Correct answer: A

Rationale: The correct instruction to include in the client's teaching plan is to report any signs of urinary tract infection. Canagliflozin, a medication used in diabetes mellitus type 2, can increase the risk of urinary tract infections. Instructing the client to report any signs of infection is crucial for early intervention and management. Choices B, C, and D are incorrect because there is no specific requirement to take canagliflozin with meals, avoid alcohol, or restrict grapefruit juice consumption while on this medication.

4. A client with a diagnosis of generalized anxiety disorder is prescribed lorazepam. The client should be informed that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Lorazepam, a medication commonly used to treat anxiety disorders, can lead to drowsiness as a common side effect. It is important for clients to be aware of this potential effect, and they should be advised to avoid activities like driving until they understand how the medication affects them. Dry mouth, nausea, and headache are possible side effects of other medications but are less commonly associated with lorazepam.

5. A client with an exacerbation of asthma is prescribed albuterol. The nurse should assess the client for which common side effect of this medication?

• A. Tremors
• B. Nausea and vomiting
• C. Insomnia
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Tremors. Albuterol, a beta-agonist medication commonly used to treat asthma exacerbations, can lead to tremors as a side effect. Tremors result from the stimulation of beta-2 receptors in muscles, particularly in the hands. Nausea and vomiting (Choice B) are generally not common side effects of albuterol. Insomnia (Choice C) is less likely to occur with albuterol, as it is a stimulant and can cause alertness rather than sleep disturbances. Dry mouth (Choice D) is not a typical side effect associated with albuterol use.

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