Nursing Elites

1. A client is prescribed lisinopril for hypertension. What potential adverse effect should the practical nurse (PN) instruct the client to monitor for?

• A. Persistent cough
• B. Constipation
• C. Increased appetite
• D. Dry skin

Correct answer: A

Rationale: Corrected Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. This cough is distinctive and different from other causes of cough. It is essential for the client to be aware of this potential side effect as it can indicate a serious issue. Instructing the client to monitor for a persistent cough and report it to the healthcare provider promptly is crucial to ensure timely intervention and management. Choices B, C, and D are incorrect as constipation, increased appetite, and dry skin are not commonly associated with lisinopril use for hypertension. Therefore, the practical nurse should focus on educating the client about monitoring and reporting a persistent cough.

2. A client with pulmonary tuberculosis has been taking rifampin for 3 weeks. The client reports orange urine. What should be the nurse's next action?

• A. Notify the client's health care provider.
• B. Inform the client that this is not harmful.
• C. Assess the client for other signs of nephrotoxicity.
• D. Monitor the client's most recent creatinine level.

Correct answer: B

Rationale: The correct action for the nurse to take when a client reports orange urine after taking rifampin is to inform the client that this change is not harmful. Rifampin is known to cause orange discoloration of urine, which is a harmless side effect. There is no need to notify the health care provider as this is an expected outcome. Monitoring creatinine levels or assessing for nephrotoxicity is unnecessary in this situation, as rifampin does not typically cause kidney damage.

3. A client with chronic kidney disease is prescribed cinacalcet. The nurse should monitor for which potential side effect?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hyperkalemia
• D. Hyperphosphatemia

Correct answer: A

Rationale: Corrected Rationale: Cinacalcet is a medication that can lower calcium levels, leading to hypocalcemia. Monitoring for signs of low calcium levels such as muscle cramps, tingling sensations, and abnormal heart rhythms is crucial to prevent complications in clients with chronic kidney disease.\nIncorrect Choices Rationale: B) Hypercalcemia is the opposite effect of cinacalcet; C) Hyperkalemia and D) Hyperphosphatemia are not typically associated with cinacalcet use.

4. A client with heart failure develops hyperaldosteronism. What dietary recommendation is essential for managing this condition?

• A. Limit intake of high potassium foods
• B. Replace salt with salt substitute
• C. Monitor skin for excessive bruising
• D. Cover your skin before going outside

Correct answer: A

Rationale: Hyperaldosteronism can lead to increased potassium retention, which can be problematic for individuals with heart failure. Limiting intake of high potassium foods is crucial to prevent hyperkalemia, a condition that can worsen heart failure. Therefore, advising the client to limit high potassium foods is essential in managing hyperaldosteronism in the setting of heart failure.

5. A client with rheumatoid arthritis is prescribed adalimumab. What instruction 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 exposure while taking this medication.

Correct answer: A

Rationale: The correct instruction for a client prescribed adalimumab, which is an immunosuppressant medication, is to avoid live vaccines. Adalimumab can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent complications and ensure the effectiveness of the treatment.

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