Nursing Elites

1. When a client is starting long-term oral prednisone for chronic asthma, what adverse effect should the nurse instruct the client to monitor for?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is a common adverse effect of oral prednisone due to sodium and water retention, which can lead to fluid retention. Monitoring weight changes is important as it helps in early identification of this adverse effect, enabling timely interventions to manage it. Choice B, nervousness, is not typically associated with oral prednisone use. Bradycardia (Choice C) is unlikely as prednisone usually causes tachycardia or increased heart rate. Constipation (Choice D) is not a common adverse effect of prednisone compared to weight gain.

2. A client is receiving heparin therapy. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?

• A. PT
• B. aPTT
• C. INR
• D. Platelet count

Correct answer: B

Rationale: The corrected answer is B: aPTT. The activated partial thromboplastin time (aPTT) is the laboratory value used to monitor the effectiveness of heparin therapy. The aPTT should be maintained at 1.5 to 2 times the normal level to ensure therapeutic anticoagulation. Monitoring aPTT helps healthcare providers adjust heparin doses to achieve the desired anticoagulant effects and prevent complications such as bleeding or clotting. Choice A, PT (prothrombin time), is used to monitor warfarin therapy, not heparin. Choice C, INR (international normalized ratio), is also used to monitor warfarin therapy. Choice D, platelet count, is important for assessing the risk of bleeding, but it does not directly monitor the effectiveness of heparin therapy.

3. 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.

4. While collecting data from a client taking Gemfibrozil, a nurse should identify which of the following assessment findings as an adverse reaction to the medication?

• A. Mental status changes
• B. Tremor
• C. Jaundice
• D. Pneumonia

Correct answer: C

Rationale: Jaundice is an adverse reaction that the nurse should identify when assessing a client taking Gemfibrozil. It is associated with liver impairment, which can be a side effect of this medication. Mental status changes and tremors are not typically associated with Gemfibrozil use. Pneumonia is not a common adverse reaction to this medication, and its occurrence is not directly linked to Gemfibrozil use.

5. A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

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