Nursing Elites

1. A client has a new prescription for Furosemide. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypernatremia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Furosemide, a diuretic, commonly causes hyponatremia (low sodium levels) as it increases the excretion of sodium. The nurse needs to monitor the client for signs of hyponatremia, such as confusion, weakness, and muscle cramps, by checking electrolyte levels regularly. Choices A, C, and D are incorrect because hyperkalemia (choice A), hypernatremia (choice C), and hypercalcemia (choice D) are not typically associated with Furosemide use.

2. A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the client should be advised to do which of the following?

• A. Avoid using acetaminophen for headaches.
• B. Restrict intake of foods rich in sodium.
• C. Decrease fluid intake to less than 1,500 mL daily.
• D. Limit aerobic activity in hot weather.

Correct answer: D

Rationale: The correct answer is to advise the client to limit aerobic activity in hot weather. Aerobic activity in hot weather can lead to excessive sweating, potentially causing sodium and water depletion, which can increase the risk of Lithium toxicity. It is important for clients taking Lithium to maintain adequate hydration and sodium levels to prevent toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting intake of foods rich in sodium is not recommended because adequate sodium levels are necessary to prevent Lithium toxicity. Decreasing fluid intake to less than 1,500 mL daily is also not advisable as adequate hydration is important to prevent Lithium toxicity.

3. When educating a client with a new prescription for albuterol, which instruction should the nurse include?

• A. Use the inhaler every 4 hours.
• B. Shake the inhaler before use.
• C. Take a deep breath before inhaling the medication.
• D. Use a spacer when using the inhaler.

Correct answer: B

Rationale: Shaking the albuterol inhaler before use is essential to ensure that the medication is evenly mixed and properly delivered when inhaled. This maximizes the effectiveness of the medication in opening the airways and relieving symptoms of bronchospasm.

4. How do ACE inhibitors work?

• A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
• B. Block stimulation of beta 1 and beta 2 at the receptor sites
• C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
• D. None of the above

Correct answer: C

Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.

5. A client has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

• A. Crushing the medication might cause you to have a stomachache or indigestion.
• B. Crushing the medication is a good idea, and I can mix it in some ice cream for you.
• C. Crushing the medication would release all the medication at once, rather than over time.
• D. Crushing is unsafe, as it destroys the ingredients in the medication.

Correct answer: A

Rationale: Crushing an enteric-coated medication can cause it to break down in the stomach instead of the intestines, potentially leading to gastrointestinal distress like stomachache or indigestion. It is important to take enteric-coated medications whole to ensure they are properly absorbed in the intestines and to prevent irritation to the stomach.

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