Nursing Elites

1. A client has a new prescription for Losartan. Which of the following laboratory values should the nurse monitor?

• A. Serum potassium
• B. Serum sodium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: Corrected Rationale: Losartan, an angiotensin II receptor blocker (ARB), can cause hyperkalemia by affecting the renin-angiotensin-aldosterone system. Monitoring serum potassium levels is crucial to detect and manage any potential hyperkalemia, which can lead to serious cardiac arrhythmias. Monitoring serum sodium, calcium, or magnesium levels is not typically required when a patient is on Losartan unless there are specific indications or comorbidities that warrant such monitoring.

2. While teaching a client with a new prescription for Warfarin, which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, found in green leafy vegetables, not potassium. The client should avoid consuming large amounts of foods high in vitamin K to maintain the effectiveness of Warfarin therapy. Increasing potassium intake is not a concern related to Warfarin therapy, so this statement indicates a need for further teaching. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding large amounts of green leafy vegetables helps prevent fluctuations in vitamin K levels, taking medication consistently maintains therapeutic levels, and reporting any signs of bleeding is essential for monitoring and managing potential side effects of Warfarin.

3. When a client has a new prescription for Dextromethorphan to suppress a cough, what adverse effect should they monitor for according to the nurse's instruction?

• A. Diarrhea
• B. Anxiety
• C. Sedation
• D. Palpitations

Correct answer: C

Rationale: The correct answer is C: Sedation. Dextromethorphan can lead to sedation as an adverse effect. The nurse should advise the client to avoid activities that require alertness when taking this medication to prevent any potential harm. Monitoring for sedation is crucial to ensure the client's safety and well-being. Choices A, B, and D are incorrect as diarrhea, anxiety, and palpitations are not commonly associated with Dextromethorphan use. While some individuals may experience gastrointestinal upset, central nervous system effects like sedation are more commonly observed.

4. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.

5. A client has a new prescription for lisinopril. Which of the following findings should the nurse monitor as an adverse effect of this medication?

• A. Cough
• B. Hyperglycemia
• C. Headache
• D. Dry mouth

Correct answer: A

Rationale: A common adverse effect of lisinopril is a persistent dry cough. Lisinopril is an ACE inhibitor that can cause irritation in the respiratory tract, leading to a cough. Monitoring for a persistent cough is essential as it may indicate a serious adverse effect that requires medical attention. Hyperglycemia (Choice B) is not a common adverse effect of lisinopril. Headache (Choice C) and dry mouth (Choice D) are not typically associated with lisinopril use. Therefore, the correct answer is A: Cough.

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