Nursing Elites

1. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?

• A. Urine specific gravity of 1.035
• B. Urine specific gravity of 444
• C. Urine specific gravity of 2000
• D. Urine specific gravity of 1111.1

Correct answer: A

Rationale: A urine specific gravity greater than 1.030 indicates dehydration. In this case, a urine specific gravity of 1.035 suggests concentrated urine, indicating dehydration. Choices B, C, and D have values that are not within the normal range for urine specific gravity and do not indicate dehydration. A urine specific gravity of 444, 2000, or 1111.1 are not physiologically possible values and are therefore incorrect.

2. A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Ecchymosis
• B. Jaundice
• C. Hypotension
• D. Hypokalemia

Correct answer: C

Rationale: The correct answer is C: Hypotension. Enalapril, an ACE inhibitor, can lead to hypotension, especially after the first dose. Choices A, B, and D are incorrect because enalapril is not typically associated with ecchymosis, jaundice, or hypokalemia as common adverse effects. Therefore, the nurse should primarily monitor the client for signs of hypotension.

3. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?

• A. Allergic response
• B. Superinfection
• C. Renal toxicity
• D. Hepatotoxicity

Correct answer: B

Rationale: Candidiasis is a type of superinfection that can occur when antibiotics, like tetracycline, disrupt the normal flora, allowing overgrowth of fungi. Option A, allergic response, is incorrect because candidiasis is not typically an allergic reaction. Option C, renal toxicity, and option D, hepatotoxicity, are incorrect as they refer to adverse effects on the kidneys and liver, respectively, which are not directly related to the development of candidiasis.

4. A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering?

• A. Amantadine
• B. Bupropion
• C. Phenelzine
• D. Hydroxyzine

Correct answer: A

Rationale: The correct answer is Amantadine. Amantadine is used to treat extrapyramidal symptoms, such as mask-like facial expressions, involuntary movements, and tremors, which are common side effects of antipsychotic medications like chlorpromazine. Bupropion is an antidepressant and not indicated for treating these symptoms. Phenelzine is a monoamine oxidase inhibitor used for depression and anxiety disorders, not for extrapyramidal symptoms. Hydroxyzine is an antihistamine used for anxiety and allergic conditions, not for the side effects described in the client.

5. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

• A. Take hydrochlorothiazide as needed for edema.
• B. Check your weight once weekly.
• C. Take the hydrochlorothiazide on an empty stomach.
• D. Take the hydrochlorothiazide in the morning.

Correct answer: D

Rationale: The correct answer is to take hydrochlorothiazide in the morning. This medication is usually advised to be taken in the morning to prevent nocturia, which is excessive urination at night. Option A is incorrect because hydrochlorothiazide should be taken daily as prescribed, not as needed for edema. Option B is incorrect as monitoring weight weekly may not be specifically related to hydrochlorothiazide therapy. Option C is incorrect as hydrochlorothiazide does not need to be taken on an empty stomach.

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