Nursing Elites

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

• A. Constipation
• B. Diarrhea
• C. Nausea
• D. Hyperphosphatemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed ferric citrate, the nurse should monitor for constipation as a potential side effect. Ferric citrate can lead to constipation due to its effects on the gastrointestinal system, causing a decrease in bowel movements. It is essential for the nurse to assess and manage constipation promptly to prevent complications and ensure the client's comfort and well-being. Monitoring bowel movements, providing adequate hydration, and recommending dietary interventions can help alleviate constipation in clients taking ferric citrate. Diarrhea, nausea, and hyperphosphatemia are not typically associated with the use of ferric citrate in clients with chronic kidney disease.

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

• A. Nausea
• B. Drowsiness
• C. Insomnia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Nausea. Sertraline, a selective serotonin reuptake inhibitor (SSRI), is known to commonly cause gastrointestinal side effects such as nausea. It is recommended for clients to take sertraline with food to help minimize this potential side effect. Choice B, Drowsiness, is less commonly associated with sertraline use. Insomnia, choice C, is not a typical side effect of sertraline; in fact, it may help improve sleep in some individuals. Headache, choice D, is also not a common side effect of sertraline.

3. What action should be taken six days after starting a prescription for oral amoxicillin solution?

• A. Determine if any other symptoms have developed
• B. Advise the use of over-the-counter antipyretics
• C. Instruct the client to increase oral fluid intake
• D. Ask if the medication has been kept refrigerated

Correct answer: A

Rationale: It is important to monitor for any new symptoms that may indicate a worsening condition or side effects when taking oral amoxicillin solution. This proactive approach helps in assessing the effectiveness and safety of the medication.

4. A patient is prescribed sucralfate (Carafate) and asks the nurse what the purpose of taking this medication is. Which is the nurse's best response?

• A. The medication helps reduce bacteria levels in the stomach
• B. The medication helps neutralize gastric acid in the stomach
• C. The medication is used to protect the gastrointestinal mucosa
• D. The medication can reduce the patient's constipation

Correct answer: C

Rationale: The correct answer is C. Sucralfate (Carafate) is used to protect the gastrointestinal mucosa by forming a protective barrier over ulcers. This barrier helps prevent stomach acid from further damaging the ulcers and promotes healing. It does not directly reduce bacteria levels, neutralize gastric acid, or have a direct effect on constipation.

5. The client is receiving vancomycin, and the nurse plans to draw blood for a peak and trough to determine... the best timing for these levels?

• A. Midway through administration of the IV dose and 30 minutes before the next
• B. Two hours after completion of the IV dose and 30 minutes before the next
• C. Two hours after completion of the IV dose and one hour before the next
• D. Immediately after completion of the IV dose and 30 minutes before

Correct answer: B

Rationale: To accurately determine peak and trough levels of vancomycin, blood should be drawn two hours after the completion of the IV dose and 30 minutes before the next dose. This timing allows for appropriate assessment of the drug levels in the body, ensuring accurate monitoring of therapeutic and toxic concentrations. Choice A is incorrect as drawing blood midway through administration does not provide an accurate peak level. Choice C is incorrect as drawing blood one hour before the next dose does not represent the trough level. Choice D is incorrect because drawing blood immediately after completion of the IV dose does not allow enough time for the drug to reach peak levels.

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