Nursing Elites

1. A client has a new prescription for Furosemide to treat heart failure. Which of the following laboratory results should the nurse monitor?

• A. Potassium level
• B. Sodium level
• C. Hemoglobin A1C
• D. BUN

Correct answer: A

Rationale: The nurse should monitor the client's potassium levels when taking Furosemide because the medication can lead to hypokalemia. Hypokalemia is a potential side effect of Furosemide, a loop diuretic, due to increased potassium excretion in the urine. Monitoring potassium levels is crucial to prevent complications such as cardiac dysrhythmias associated with low potassium levels. Therefore, choices B (Sodium level), C (Hemoglobin A1C), and D (BUN) are incorrect as they are not directly influenced by Furosemide therapy for heart failure.

2. A client has a new prescription for hydrochlorothiazide. The client should monitor for which of the following adverse effects?

• A. Hyponatremia
• B. Ototoxicity
• C. Hypoglycemia
• D. Hyperkalemia

Correct answer: A

Rationale: Hyponatremia is a potential adverse effect of hydrochlorothiazide due to its diuretic action. Hydrochlorothiazide is a thiazide diuretic that can cause sodium and water loss, potentially leading to hyponatremia. Monitoring for symptoms such as weakness, confusion, and muscle cramps can help detect hyponatremia early. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) is not typically associated with hydrochlorothiazide use. Hyperkalemia (choice D) is more commonly associated with potassium-sparing diuretics rather than thiazide diuretics like hydrochlorothiazide.

3. A healthcare provider in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings are indicative of this condition?

• A. Insidious onset of painless loss of vision
• B. Gradual reduction in peripheral vision
• C. Severe pain around the eyes
• D. Intraocular pressure of 12mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a characteristic symptom of acute angle-closure glaucoma. This intense pain is typically accompanied by other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. The acute rise in intraocular pressure leads to these symptoms, indicating a medical emergency that requires immediate attention to prevent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more suggestive of conditions like age-related macular degeneration or diabetic retinopathy. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12mm Hg is within the normal range and not indicative of the acute rise seen in angle-closure glaucoma.

4. A healthcare provider is providing teaching to a client who has a new prescription for metronidazole. The healthcare provider should instruct the client to avoid which of the following?

• A. Dairy products
• B. Alcohol
• C. Leafy green vegetables
• D. Grapefruit juice

Correct answer: B

Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole due to the risk of a disulfiram-like reaction. This reaction can cause symptoms like flushing, headache, nausea, and vomiting when alcohol is consumed while on metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole. Dairy products do not interfere with metronidazole absorption; leafy green vegetables are safe to consume as they do not affect metronidazole metabolism, and grapefruit juice is not contraindicated with metronidazole.

5. A client has a new prescription for Lovastatin. Which of the following instructions should be included?

• A. Take this medication on an empty stomach.
• B. Take this medication in the morning.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: Lovastatin should be taken at bedtime because cholesterol production in the liver is highest at night, making the medication more effective in reducing cholesterol levels. By taking it at bedtime, the medication aligns with the body's natural rhythm of cholesterol synthesis, optimizing its therapeutic effects.

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