Nursing Elites

1. A client with chronic heart failure is prescribed furosemide. The nurse should monitor the client for which potential adverse effect?

• A. Increased blood glucose levels
• B. Electrolyte imbalance
• C. Dehydration
• D. Weight gain

Correct answer: C

Rationale: When a client with chronic heart failure is prescribed furosemide, a diuretic, the nurse should be vigilant for potential adverse effects. Furosemide can lead to excessive fluid loss, resulting in dehydration. Dehydration is a significant concern as it can exacerbate heart failure symptoms. Additionally, furosemide can cause electrolyte imbalances, particularly affecting potassium and sodium levels. Monitoring for signs of dehydration and electrolyte disturbances is crucial to prevent complications and ensure the client's safety and well-being. Increased blood glucose levels and weight gain are not commonly associated with furosemide use in heart failure patients, making choices A and D incorrect.

2. A client with a history of myocardial infarction is prescribed atorvastatin. The nurse should monitor the client for which potential adverse effect?

• A. Liver damage
• B. Kidney damage
• C. Muscle pain
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Muscle pain. Atorvastatin can cause muscle pain, which may indicate rhabdomyolysis, a serious adverse effect. Rhabdomyolysis is a condition where muscle breakdown releases a protein (myoglobin) into the bloodstream, potentially leading to kidney damage. Liver damage (choice A) is a less common side effect of atorvastatin compared to muscle pain. Kidney damage (choice B) is not a direct adverse effect of atorvastatin but can occur indirectly if rhabdomyolysis is severe. Increased appetite (choice D) is not a known adverse effect of atorvastatin.

3. What information should the practical nurse provide to a female client who started taking an oral sulfonamide for a urinary tract infection the previous day and reports slight anorexia, while also experiencing urinary frequency?

• A. Take the medication with an antacid instead of cranberry juice to reduce the anorexia.
• B. Continue to take the medication with a sip of cranberry juice, restricting fluids until the frequency is controlled.
• C. Continue to drink cranberry juice, but take the medicine on an empty stomach with a full glass of water.
• D. Take the medication with a spoonful of ice cream or applesauce and avoid drinking cranberry juice.

Correct answer: C

Rationale: The practical nurse should advise the client to take sulfonamides with a full glass of water to help prevent crystalluria. It is essential to take the medication on an empty stomach, ideally 1 hour before eating or 2 hours after eating to maximize its absorption and effectiveness. Continuing to drink cranberry juice is beneficial, but it is important to take the medicine separately to enhance its therapeutic action.

4. A client with a diagnosis of generalized anxiety disorder is prescribed hydroxyzine. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Hydroxyzine is known to cause drowsiness, so clients should be advised to avoid activities like driving until they understand how the medication affects them. Choices B, C, and D are incorrect because dry mouth, nausea, and headache are not commonly associated with hydroxyzine use. It is crucial for the client to be aware of the potential drowsiness to ensure their safety and well-being while taking this medication.

5. A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed salmeterol. The nurse should monitor for which potential side effect?

• A. Dry mouth
• B. Tachycardia
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: The correct answer is dry mouth. Salmeterol, a long-acting beta agonist used in COPD, can lead to dry mouth as a common side effect. Nurses should monitor for this side effect and advise clients to report it if it becomes bothersome.

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