Nursing Elites

1. A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?

• A. I will avoid potassium-rich foods.
• B. I will not use a salt substitute.
• C. I will monitor my weight daily.
• D. I will increase my fluid intake as prescribed.

Correct answer: A

Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.

2. A client is being taught about the use of nitroglycerin (Nitrostat) for angina. Which statement by the client indicates a need for further teaching?

• A. I will sit or lie down when I take the medication.
• B. I can take up to three tablets, 5 minutes apart, if needed.
• C. I will call 911 if my chest pain is not relieved after taking three tablets.
• D. I will keep the medication in its original dark container.

Correct answer: B

Rationale: The correct administration of nitroglycerin for angina is to take up to three tablets, 5 minutes apart. If the chest pain persists after the third tablet, emergency medical services should be called. Taking more than three tablets or reducing the time interval between doses may lead to hypotension and indicates a need for further teaching.

3. When a client is taking lansoprazole (Prevacid), which question should the nurse ask during data collection to determine medication effectiveness?

• A. Has your appetite increased?
• B. Are you experiencing any heartburn?
• C. Do you have any problems with vision?
• D. Do you experience any leg pain when walking?

Correct answer: B

Rationale: When a client is taking lansoprazole (Prevacid), a gastric acid pump inhibitor used to treat gastroesophageal reflux disease (GERD), the nurse should ask if the client is experiencing any heartburn to determine medication effectiveness. Heartburn is a common symptom of GERD, and the reduction of heartburn indicates the effectiveness of lansoprazole in managing acid reflux symptoms. Choices A, C, and D are not relevant to assessing the effectiveness of lansoprazole for GERD.

4. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A healthcare provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?

• A. 3 to 5 ng/mL
• B. 0.5 to 2 ng/mL
• C. 1.2 to 2.8 ng/mL
• D. 3.5 to 5.5 ng/mL

Correct answer: B

Rationale: The therapeutic serum level for digoxin ranges from 0.5 to 2 ng/mL. This range is considered optimal for therapeutic effects while minimizing the risk of toxicity. Levels above 2 ng/mL may lead to digoxin toxicity, which can manifest as anorexia among other symptoms. Therefore, the nurse should be vigilant in monitoring the digoxin levels to ensure the client's safety and therapeutic effectiveness of the medication.

5. A healthcare provider has written a prescription for ranitidine (Zantac), once daily. When should the nurse schedule the medication?

• A. At bedtime
• B. After lunch
• C. With supper
• D. Before breakfast

Correct answer: A

Rationale: The correct answer is A: At bedtime. Ranitidine should be scheduled at bedtime because it provides a prolonged effect and offers the greatest protection of the gastric mucosa. Administering it at this time helps in managing nocturnal acid breakthrough and providing relief during the night.

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