Nursing Elites

1. What side effect is a male client likely to experience while receiving furosemide 40mg by mouth?

• A. Difficulty starting urination
• B. Nosebleeds
• C. Muscle cramps
• D. Visual disturbances

Correct answer: C

Rationale: Muscle cramps are a common side effect of furosemide due to its impact on electrolyte levels, especially potassium. Furosemide is a loop diuretic that can lead to potassium depletion, resulting in muscle cramps as one of the manifestations of electrolyte imbalances. Therefore, choices A, B, and D are incorrect. Difficulty starting urination is not a common side effect of furosemide; nosebleeds and visual disturbances are not typically associated with this medication.

2. The nurse is studying antacids that contain magnesium and calcium for the pharmacology exam. The student nurse remembers that these antacids should be used with caution in patients with which condition?

• A. Hypertension
• B. Renal failure
• C. Heart failure
• D. Peptic ulcer disease

Correct answer: B

Rationale: Magnesium and calcium can accumulate in patients with renal failure, leading to toxicity.

3. A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?

• A. Avoid using artificial tears because they decrease the efficacy of cyclosporine.
• B. Discontinue the use of both products if transient blurring occurs after administration.
• C. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
• D. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level.

Correct answer: C

Rationale: The correct answer is to allow a 15-minute interval between the administration of cyclosporine and artificial tears. Cyclosporine, an ophthalmic emulsion that increases tear production, can be used in conjunction with artificial tears as long as the products are administered 15 minutes apart. This interval helps to prevent any potential interactions between the two products and ensures optimal effectiveness of cyclosporine for treating dry eyes.

4. After receiving the third dose of a new oral anticoagulant prescription, which action should the nurse implement? Select all that apply.

• A. Notify the healthcare provider of the finding
• B. Provide a PRN NSAID for gum discomfort
• C. Review the most recent coagulation lab values
• D. Complete a medication variance report

Correct answer: C

Rationale: Reviewing the most recent coagulation lab values is crucial after receiving multiple doses of a new oral anticoagulant to ensure the patient is within the desired therapeutic range and to prevent adverse events related to over or under-anticoagulation. It is essential to monitor these values closely to adjust the dosage if needed. Notifying the healthcare provider of any concerning findings is important, but it may not be the immediate priority after receiving the third dose. Providing a PRN NSAID for gum discomfort is not typically indicated with oral anticoagulant therapy, as it may increase the risk of bleeding. Completing a medication variance report is more relevant in cases of medication errors or discrepancies, which may not apply in this scenario.

5. A client with anxiety is prescribed alprazolam. What instruction should the nurse include in the client's teaching plan?

• A. Take this medication with food.
• B. Avoid activities that require alertness.
• C. Do not stop taking this medication abruptly.
• D. This medication may cause drowsiness.

Correct answer: C

Rationale: The correct answer is C: 'Do not stop taking this medication abruptly.' Alprazolam should not be stopped suddenly as it can lead to withdrawal symptoms. It is important for clients to taper off the medication gradually under medical supervision to prevent adverse effects. Choices A, B, and D are incorrect. Choice A is irrelevant to alprazolam administration instructions. Choice B, 'Avoid activities that require alertness,' is not the priority teaching point for alprazolam. Choice D, 'This medication may cause drowsiness,' is a common side effect of alprazolam but not the most critical instruction to include in the teaching plan.

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