Nursing Elites

1. Twenty-four hours after starting to take oral penicillin for strep throat, a client calls the nurse to report the onset of a rash on the chest. What action should the nurse implement?

• A. Instruct the client to discontinue the penicillin immediately
• B. Instruct the client regarding the use of topical analgesic cream PRN
• C. Question the client about any other related symptoms
• D. Reinforce the need to take all doses of the penicillin

Correct answer: A

Rationale: In this scenario, the client has developed a rash after starting oral penicillin, which can indicate an allergic reaction. It is crucial for the nurse to instruct the client to discontinue the penicillin immediately. Continuing the medication can potentially lead to severe allergic reactions. Instructing about topical analgesic cream or questioning about other related symptoms may delay appropriate action in case of a severe allergic reaction. Reinforcing the need to complete all doses is not appropriate when an allergic reaction is suspected, as safety takes precedence over completing the antibiotic course.

2. A client with a history of atrial fibrillation is prescribed verapamil. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: Verapamil, a calcium channel blocker, can commonly cause constipation due to its effects on smooth muscle relaxation in the gastrointestinal tract. Therefore, monitoring for constipation is important when a client is prescribed verapamil.

3. 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.

4. A client with a diagnosis of generalized anxiety disorder is prescribed buspirone. The nurse should include which instruction in the client's teaching plan?

• A. This medication may cause drowsiness; avoid driving.
• B. This medication may take several weeks to take effect.
• C. This medication can be taken on an as-needed basis.
• D. This medication should be taken with food.

Correct answer: B

Rationale: Buspirone may take several weeks to take effect, so clients should continue taking it as prescribed and not expect immediate relief.

5. Phenytoin is prescribed for a client who has a seizure disorder. Which statement by the client needs to be clarified by the healthcare provider?

• A. I should notify the healthcare provider if the color of my urine turns pink.
• B. I should never stop taking this medication abruptly.
• C. I should monitor my glucose levels closely since I am diabetic.
• D. I should take the medicine with antacids if gastric upset occurs.

Correct answer: D

Rationale: The correct answer is D because antacids should not be taken with phenytoin as they can decrease its effects. Taking antacids with phenytoin is not recommended. Choice A is correct; pink discoloration of urine can occur with phenytoin use. Choice B is also correct; abruptly stopping phenytoin can lead to seizures. Choice C is correct; monitoring glucose levels is important as phenytoin can increase glucose levels. Therefore, the statement about using antacids with phenytoin needs clarification.

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