Nursing Elites

1. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

2. A client with peptic ulcer disease is prescribed sucralfate. Which of the following instructions should the nurse include?

• A. Take sucralfate with meals.
• B. Take sucralfate 1 hr before meals.
• C. Take sucralfate with antacids.
• D. Take sucralfate 2 hours after meals.

Correct answer: B

Rationale: The correct instruction for taking sucralfate is 1 hour before meals. This timing allows sucralfate to effectively coat the stomach lining and provide a protective barrier against gastric acid, helping to prevent ulcers.

3. A client has a new prescription for Spironolactone. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia due to its mechanism of action. Hyperkalemia can cause muscle weakness and cardiac dysrhythmias. Therefore, the nurse should educate the client to monitor for signs and symptoms of hyperkalemia while taking Spironolactone.

4. When caring for a client prescribed Digoxin, which of the following laboratory values should the nurse monitor to assess for potential toxicity?

• A. Sodium
• B. Potassium
• C. Magnesium
• D. Calcium

Correct answer: B

Rationale: When a client is prescribed Digoxin, monitoring potassium levels is crucial as hypokalemia can increase the risk of Digoxin toxicity. Low potassium levels can potentiate the effects of Digoxin on the heart, leading to toxicity. Therefore, regular monitoring of potassium levels helps in preventing adverse effects and ensuring the safe use of Digoxin. Sodium, magnesium, and calcium levels are not directly associated with Digoxin toxicity; hence, they are not the primary focus for monitoring in this case.

5. When caring for a school-age child with a new prescription for Atomoxetine, the nurse should monitor the client for which of the following adverse effects of this medication?

• A. Kidney toxicity
• B. Liver damage
• C. Seizure activity
• D. Adrenal insufficiency

Correct answer: B

Rationale: The correct answer is B: Liver damage. Atomoxetine can lead to liver damage as an adverse effect. Symptoms of liver damage include jaundice, upper abdominal tenderness, dark urine, and elevated liver enzymes. Monitoring for these signs is crucial when a child is on this medication. Choices A, C, and D are incorrect because Atomoxetine is not known to cause kidney toxicity, seizure activity, or adrenal insufficiency as primary adverse effects.

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