Nursing Elites

1. A client with chronic kidney disease is prescribed calcium acetate. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed calcium acetate, the nurse must monitor for hypercalcemia, not hypocalcemia, hyperkalemia, or hypokalemia. Calcium acetate can increase calcium levels in the blood, leading to hypercalcemia. Symptoms of hypercalcemia include fatigue, confusion, constipation, and muscle weakness. Regular monitoring of calcium levels is crucial to prevent complications associated with elevated calcium levels.

2. A client with a history of atrial fibrillation is prescribed apixaban. The nurse should monitor for which potential side effect?

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Bleeding. Apixaban is an anticoagulant medication that works by decreasing the blood's ability to clot. One of the significant side effects of apixaban is an increased risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in the urine or stool, or unusual bleeding or bruising. Monitoring for these signs is crucial to prevent or manage any potential complications associated with the medication. Choices B, C, and D are incorrect because weight gain, headache, and nausea are not typically associated with apixaban use. Therefore, the nurse should primarily focus on monitoring for signs of bleeding in a client prescribed apixaban.

3. A client with hypertension is prescribed valsartan. The nurse should monitor the client for which potential side effect?

• A. Hypotension
• B. Tachycardia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Hypotension. Valsartan is an angiotensin II receptor blocker that can cause hypotension as a side effect by dilating blood vessels. Monitoring blood pressure is crucial to prevent complications related to low blood pressure. Choice B, Tachycardia, is incorrect because valsartan typically does not cause an increase in heart rate. Choice C, Hyperglycemia, is not a common side effect of valsartan. Choice D, Hyponatremia, is also unlikely with valsartan use.

4. A client with gastroesophageal reflux disease (GERD) is prescribed omeprazole. The nurse should reinforce which instruction?

• A. Take this medication in the morning before breakfast.
• B. Take this medication with meals.
• C. Avoid taking this medication with antacids.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client with GERD prescribed omeprazole is to take the medication in the morning before breakfast. Omeprazole works best when taken on an empty stomach, approximately 30 minutes before the first meal of the day. This timing maximizes its effectiveness in reducing stomach acid production and helps manage symptoms of GERD more efficiently. Choice B is incorrect because taking omeprazole with meals may reduce its efficacy as it needs an empty stomach for optimal absorption. Choice C is incorrect because omeprazole can be taken with or without food, but it should not be taken with antacids as they can affect its absorption. Choice D is incorrect because taking omeprazole at bedtime is less effective compared to taking it before breakfast due to the circadian rhythm of gastric acid secretion.

5. The practical nurse administers lactulose to a client. Which client outcome would indicate a therapeutic response?

• A. An increase in urine output
• B. Two to three soft stools per day
• C. Absence of nausea
• D. Decreased serum potassium

Correct answer: B

Rationale: Lactulose is a type of laxative that works by preventing the absorption of ammonia in the colon, leading to increased water absorption in the stool and softening of the stool. The therapeutic response to lactulose is indicated by the passage of two to three soft stools per day, showing that the medication is effectively promoting bowel movements.

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