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 deep vein thrombosis is prescribed enoxaparin. The nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: Enoxaparin is an anticoagulant that works by preventing blood clots. One of the potential adverse effects of enoxaparin is an increased risk of bleeding due to its anticoagulant properties. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, petechiae, or blood in stool or urine, to ensure timely intervention and prevent complications.

3. A client with a history of stroke is prescribed dabigatran. The nurse should monitor for which potential side effect?

• A. Dry mouth
• B. Weight gain
• C. Headache
• D. Dizziness

Correct answer: C

Rationale: The correct answer is C: Headache. Dabigatran, an anticoagulant, can cause headache as a potential side effect. Headache is important to monitor as it may indicate adverse effects or complications that need attention. Choices A, B, and D are incorrect because dry mouth, weight gain, and dizziness are not commonly associated with dabigatran use.

4. A client with osteoporosis is prescribed raloxifene. The nurse should reinforce which instruction?

• A. Take this medication at the same time each day.
• B. Take this medication with a full glass of water.
• C. Take this medication on an empty stomach.
• D. Take this medication immediately after a meal.

Correct answer: A

Rationale: The correct instruction for a client prescribed raloxifene, a medication used for osteoporosis, is to take it at the same time each day. This consistency helps maintain steady blood levels of the medication, enhancing its effectiveness in managing the condition. Choice B is incorrect because raloxifene does not require a full glass of water for administration. Choice C is incorrect as raloxifene should not be taken on an empty stomach. Choice D is incorrect as raloxifene should not be taken immediately after a meal.

5. A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?

• A. Dilute the available heparin in 250ml of normal saline solution prior to IV administration
• B. Advise the pharmacy on the need to deliver a vial of heparin to the nursing unit immediately
• C. Calculate and administer the equivalent dose of the available low molecular weight heparin
• D. Request a prescription to change the route of administration and use the available heparin

Correct answer: B

Rationale: In this scenario, the nurse should contact the pharmacy to obtain the correct heparin formulation as the prescription calls for heparin 1,000 units IV STAT. Low molecular weight heparin is not the same as unfractionated heparin, and therefore, the nurse should not administer the available low molecular weight heparin without first obtaining the correct medication. Diluting the available heparin, calculating an equivalent dose, or changing the route of administration would not address the discrepancy between the prescribed heparin and the available low molecular weight heparin.

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