Nursing Elites

1. A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.

2. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The correct action for the healthcare professional preparing to administer IV Hydromorphone to a client is to administer the medication over 5 minutes. This slow administration is crucial to reduce the risk of hypotension and respiratory depression. Administering the medication rapidly can lead to adverse effects. Option B, administering Naloxone prior to Hydromorphone, is incorrect because Naloxone is used as an antidote for opioid overdose, not as a routine pre-medication. Option C, assessing the client's blood pressure before administration, is important but not the immediate action to take to reduce adverse effects of Hydromorphone. Option D, injecting the medication into the client's subcutaneous tissue, is incorrect as Hydromorphone is meant for intravenous administration for rapid onset of action.

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

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

Correct answer: A

Rationale: Corrected Rationale: Hydrochlorothiazide, a diuretic, can lead to electrolyte imbalances, particularly hyponatremia (low sodium levels). The nurse should closely monitor the client's sodium levels due to the potential adverse effect of Hydrochlorothiazide. Incorrect Rationales: - Hyperkalemia (Choice B) is less likely to be caused by Hydrochlorothiazide; in fact, it can lead to hypokalemia. - Hypercalcemia (Choice C) is not a common adverse effect of Hydrochlorothiazide. - Hypoglycemia (Choice D) is not directly associated with Hydrochlorothiazide use.

4. A healthcare professional is preparing to administer IV Furosemide to a client with heart failure. Which of the following actions should the healthcare professional take?

• A. Administer the medication undiluted.
• B. Dilute the medication with normal saline.
• C. Administer the medication through a central line.
• D. Administer the medication slowly over 2 minutes.

Correct answer: D

Rationale: Furosemide, when administered intravenously, should be given slowly over 2 minutes to reduce the risk of ototoxicity, a known adverse effect of rapid infusion. This method allows for better monitoring of the client's response and decreases the likelihood of adverse reactions associated with a faster administration rate.

5. A patient with hypertension is taking an ACE inhibitor to lower blood pressure. What should the nurse advise the patient to avoid in their diet?

• A. Vinegar
• B. Apples
• C. Salt substitutes
• D. Tomatoes

Correct answer: C

Rationale: Patients taking ACE inhibitors should avoid salt substitutes as they often contain potassium, which can lead to hyperkalemia. Hyperkalemia is an elevated level of potassium in the blood that can be dangerous, especially for patients on ACE inhibitors. Vinegar, apples, and tomatoes do not pose a risk for patients taking ACE inhibitors. Therefore, the nurse should advise the patient to avoid salt substitutes to prevent potential complications.

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