Nursing Elites

1. A 59-year-old client is prescribed furosemide 40 mg twice a day for the management of heart failure. The practical nurse should monitor the client for the development of which complication?

• A. Hypokalemia
• B. Hyperchloremia
• C. Hypercalcemia
• D. Hypophosphatemia

Correct answer: A

Rationale: Corrected Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and chloride in the kidneys, leading to increased potassium excretion and potentially causing hypokalemia. Hypokalemia can lead to cardiac irregularities, making it crucial for the practical nurse to monitor the client for this electrolyte imbalance. Choice B, Hyperchloremia, is not typically associated with furosemide use. Choices C and D, Hypercalcemia and Hypophosphatemia, are not common complications of furosemide therapy.

2. A client with a history of heart failure is prescribed carvedilol. The nurse should monitor the client for which adverse effect?

• A. Dizziness upon standing
• B. Weight loss
• C. Bradycardia
• D. Hypotension

Correct answer: D

Rationale: The correct answer is D: Hypotension. Carvedilol, a beta-blocker, can lead to hypotension by blocking the effects of adrenaline, which can cause blood vessels to dilate and reduce blood pressure. While dizziness upon standing is a potential adverse effect of carvedilol, it is more specifically related to orthostatic hypotension, which is a form of hypotension that occurs when a person stands up from a sitting or lying position. Weight loss and bradycardia are not typically associated with carvedilol use. Therefore, the nurse should primarily monitor for hypotension in a client taking carvedilol.

3. A client with osteoporosis is prescribed alendronate. The practical nurse (PN) should reinforce which instruction regarding the administration of this medication?

• A. Take the medication with a full glass of water before breakfast.
• B. Take the medication immediately after a meal.
• C. Lie down for 30 minutes after taking the medication.
• D. Crush the medication and mix it with food.

Correct answer: A

Rationale: The correct instruction for administering alendronate is to take the medication with a full glass of water before breakfast. This timing is crucial to ensure proper absorption in the body and reduce the risk of esophageal irritation. Taking it immediately after a meal or lying down for 30 minutes after may affect absorption and increase the risk of adverse effects. It should not be crushed or mixed with food to maintain its effectiveness.

4. What is the primary nursing intervention that the practical nurse should perform before administering ampicillin to a client diagnosed with a urinary tract infection?

• A. Obtain a clean-catch urine specimen.
• B. Assess the urine pH for acidity.
• C. Insert an indwelling catheter.
• D. Assess for complaints of dysuria.

Correct answer: A

Rationale: The correct answer is to obtain a clean-catch urine specimen. Before administering ampicillin to a client with a urinary tract infection, it is crucial to collect a urine specimen to determine the causative organism and evaluate the effectiveness of pharmacological therapy. Assessing the urine pH for acidity (choice B) is not the primary intervention needed before administering ampicillin. Inserting an indwelling catheter (choice C) is invasive and not necessary unless indicated for specific reasons. Assessing for complaints of dysuria (choice D) is important but does not take precedence over obtaining a urine specimen for proper diagnosis and treatment.

5. A client with rheumatoid arthritis is prescribed tofacitinib. What should the nurse include in the client's teaching plan?

• A. Avoid live vaccines while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Report any signs of infection to the healthcare provider.
• D. Avoid sunlight while taking this medication.

Correct answer: A

Rationale: Tofacitinib is an immunosuppressive medication used in rheumatoid arthritis. Patients taking tofacitinib should avoid live vaccines because the medication can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent any complications related to live vaccines during their treatment.

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