Nursing Elites

1. A client with a history of hypertension is prescribed hydrochlorothiazide (HCTZ). Which adverse effect should the nurse monitor for?

• A. Hyperkalemia
• B. Hyponatremia
• C. Bradycardia
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is 'B. Hyponatremia.' Hydrochlorothiazide can lead to electrolyte imbalances, such as hyponatremia, due to its diuretic effect. This potential adverse effect should be closely monitored in patients taking HCTZ. Choice A, hyperkalemia, is less likely to occur with HCTZ as it tends to cause hypokalemia. Choice C, bradycardia, is not a common adverse effect of HCTZ. Choice D, hyperglycemia, is also less commonly associated with HCTZ use compared to hyponatremia.

2. The nurse is caring for a client who has just undergone a total hip replacement. Which intervention is most important to prevent postoperative complications?

• A. Encourage early ambulation
• B. Apply ice to the surgical site
• C. Monitor the surgical site for signs of infection
• D. Administer pain medication as prescribed

Correct answer: A

Rationale: Encouraging early ambulation is crucial following a total hip replacement surgery as it helps prevent complications such as deep vein thrombosis (DVT) by promoting circulation. Early ambulation also aids in preventing pneumonia, muscle atrophy, and pressure ulcers. Applying ice to the surgical site may help with pain and swelling, but it is not as critical in preventing complications as early ambulation. While monitoring the surgical site for signs of infection is important, it is not as crucial in preventing postoperative complications compared to early ambulation. Administering pain medication as prescribed is essential for comfort and pain management but does not directly prevent postoperative complications like early ambulation does.

3. A client with a diagnosis of hypertension is prescribed a thiazide diuretic. Which potential side effect should the nurse monitor for?

• A. Hyperkalemia
• B. Hypernatremia
• C. Hypokalemia
• D. Hypoglycemia

Correct answer: C

Rationale: The correct answer is C: 'Hypokalemia.' Thiazide diuretics commonly cause potassium loss, which can lead to hypokalemia. Monitoring potassium levels is essential when a client is taking thiazide diuretics to prevent complications such as cardiac dysrhythmias. Choices A, B, and D are incorrect. Hyperkalemia (choice A) is an elevated level of potassium, which is not typically associated with thiazide diuretics. Hypernatremia (choice B) is an elevated level of sodium, and hypoglycemia (choice D) is low blood sugar, neither of which are directly linked to thiazide diuretic use.

4. The nurse observes a client with new-onset tachycardia. What should the nurse do first?

• A. Check for the client's temperature
• B. Administer prescribed beta-blockers
• C. Assess for any chest pain or discomfort
• D. Monitor the client's blood pressure

Correct answer: C

Rationale: When a client presents with new-onset tachycardia, the first action the nurse should take is to assess for any associated symptoms like chest pain or discomfort. This is important to differentiate the potential causes of tachycardia and guide appropriate interventions. Checking the client's temperature (Choice A) may be relevant in certain situations but is not the priority when tachycardia is observed. Administering prescribed beta-blockers (Choice B) should only be done after a comprehensive assessment and healthcare provider's orders. Monitoring the client's blood pressure (Choice D) is important, but assessing for chest pain or discomfort takes precedence in this scenario to rule out cardiac causes of tachycardia.

5. A client with a diagnosis of deep vein thrombosis (DVT) is receiving anticoagulant therapy. Which instruction should the nurse provide to the client?

• A. Avoid walking as much as possible
• B. Report any signs of bleeding to the healthcare provider
• C. Take aspirin for additional pain relief
• D. Wear compression stockings at night

Correct answer: B

Rationale: Reporting signs of bleeding is essential while on anticoagulant therapy to prevent complications.

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