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. A client with gastroesophageal reflux disease (GERD) is prescribed omeprazole. The nurse should reinforce which instruction?

• A. Take this medication in the morning before breakfast.
• B. Take this medication with meals.
• C. Avoid taking this medication with antacids.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client with GERD prescribed omeprazole is to take the medication in the morning before breakfast. Omeprazole works best when taken on an empty stomach, approximately 30 minutes before the first meal of the day. This timing maximizes its effectiveness in reducing stomach acid production and helps manage symptoms of GERD more efficiently. Choice B is incorrect because taking omeprazole with meals may reduce its efficacy as it needs an empty stomach for optimal absorption. Choice C is incorrect because omeprazole can be taken with or without food, but it should not be taken with antacids as they can affect its absorption. Choice D is incorrect because taking omeprazole at bedtime is less effective compared to taking it before breakfast due to the circadian rhythm of gastric acid secretion.

3. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. The nurse should instruct the client to report which potential side effect?

• A. Dry mouth
• B. Blurred vision
• C. Nausea
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Dry mouth. Tiotropium, a commonly prescribed medication for COPD, can cause dry mouth as a side effect. While it may not be severe, clients should report it if it becomes bothersome. Dry mouth is a common side effect of tiotropium due to its anticholinergic properties. Blurred vision, nausea, and tachycardia are not typically associated with tiotropium use in the context of COPD.

4. When educating a client about the adverse effects of conjunctivitis, what is a serious condition that requires prompt attention?

• A. Contact lens irritation
• B. Decreased sex drive
• C. Brown spots on the skin
• D. Epigastric pain unrelieved by antacids

Correct answer: D

Rationale: Epigastric pain unrelieved by antacids is a concerning symptom that may indicate a more serious underlying condition such as a perforated ulcer. This symptom requires immediate medical attention to prevent further complications.

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

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

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed sevelamer carbonate, the nurse should monitor for hypercalcemia as a potential side effect. Sevelamer carbonate can bind to dietary calcium and impair its absorption, potentially leading to elevated calcium levels in the blood. Monitoring calcium levels is crucial to detect and manage hypercalcemia promptly. Hypocalcemia (choice B) is incorrect because sevelamer carbonate's action is more likely to cause elevated calcium levels. Hyperkalemia (choice C) and hypokalemia (choice D) are related to potassium levels and are not typically associated with sevelamer carbonate use.

Similar Questions