Nursing Elites

1. A client receiving nitrofurantoin (Macrodantin) calls the health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?

• A. Nausea
• B. Diarrhea
• C. Anorexia
• D. Cough and chest pain

Correct answer: D

Rationale: Pulmonary reactions such as cough and chest pain are serious side effects associated with nitrofurantoin that require immediate discontinuation of the medication to prevent potential severe respiratory complications.

2. A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:

• A. Avoid drinking alcohol.
• B. Report yellow eyes or skin immediately.
• C. Avoid Swiss or aged cheeses.
• D. Avoid vitamin supplements during therapy.

Correct answer: B

Rationale: When a client is on isoniazid (INH) therapy, they should be instructed to report any signs of hepatitis, such as yellowing of the eyes or skin, immediately. Alcohol consumption should be avoided during INH therapy due to the risk of hepatotoxicity. Foods high in tyramine, such as Swiss or aged cheeses, should also be avoided to prevent adverse reactions. Additionally, while on INH therapy, it is essential to avoid vitamin supplements containing pyridoxine (vitamin B6) to prevent potential interactions.

3. Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client's health history, knowing that this medication is contraindicated if which of the following disorders is present?

• A. Headaches
• B. Liver disease
• C. Hypothyroidism
• D. Diabetes mellitus

Correct answer: B

Rationale: Carbamazepine (Tegretol) is contraindicated in liver disease due to its potential to cause hepatic toxicity. Regular monitoring of liver function tests is necessary when using this medication to detect any signs of liver damage.

4. A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication?

• A. Diarrhea
• B. Weakness
• C. Headache
• D. Constipation

Correct answer: D

Rationale: Constipation is a common side effect of iron supplements such as ferrous sulfate. Iron can cause constipation by slowing down the movement of the digestive system and hardening the stool. Patients should be advised to increase their fluid intake, dietary fiber, and physical activity to help alleviate this side effect. Diarrhea (Choice A) is not a common side effect associated with ferrous sulfate. Weakness (Choice B) and headache (Choice C) are not typically linked to this medication.

5. A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:

• A. Both are weak potassium-losing diuretics.
• B. The combination of these medications prevents renal toxicity.
• C. Hydrochlorothiazide is less expensive, so using a combination of diuretics is cost-effective.
• D. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.

Correct answer: D

Rationale: The combination of triamterene and hydrochlorothiazide is used because triamterene is a potassium-sparing diuretic, which helps retain potassium, while hydrochlorothiazide is a potassium-losing diuretic, which promotes potassium excretion. This combination helps balance potassium levels in the body, preventing imbalances that can occur when using potassium-losing diuretics alone.

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