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. In the emergency department, a child is admitted for accidental ingestion of a poison. The practical nurse (PN) should know that inducing vomiting is recommended for which child?

• A. An 8-month-old who ingested four to six ibuprofen tablets
• B. A 3-year-old who drank an unknown amount of charcoal lighter fluid
• C. A 16-month-old who ingested 2 ounces of acetaminophen elixir
• D. A 2-year-old who ate a handful of automatic dishwasher detergent

Correct answer: C

Rationale: Inducing emesis is recommended for the child who ingested a large dose of acetaminophen elixir because this medication is hepatotoxic. Acetaminophen overdose can lead to severe liver damage, and prompt removal from the stomach can help reduce absorption and potential harm.

3. A healthcare professional prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's heart rate is 48 beats/min, respirations are 16 breaths/min, and blood pressure is 150/90 mmHg.

• A. Administer the dose and monitor the client's blood pressure regularly
• B. Apply a telemetry monitor before administering the dose
• C. Assess for orthostatic hypotension before administering the dose
• D. Withhold the scheduled dose and notify the healthcare provider

Correct answer: D

Rationale: The client's low heart rate of 48 beats/min indicates bradycardia, a potential side effect of labetalol. Administering the dose in this case could further lower the heart rate, potentially causing adverse effects. Therefore, it is crucial to withhold the scheduled dose and notify the healthcare provider for further assessment and guidance. Choice A is incorrect because administering the dose without addressing the bradycardia can exacerbate the condition. Choice B is not relevant in this situation as telemetry monitoring is not the priority. Choice C is also not the priority in this case, as the focus should be on the client's bradycardia and the potential adverse effects of administering labetalol.

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. A client is prescribed ondansetron for nausea and vomiting. The nurse should monitor the client for which potential adverse effect?

• A. Headache
• B. Diarrhea
• C. Constipation
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Constipation. Ondansetron is known to cause constipation as a potential adverse effect. It is important for the nurse to monitor the client for constipation while on this medication to address any issues promptly. Choices A, B, and D are incorrect because headache, diarrhea, and increased appetite are not common adverse effects associated with ondansetron.

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