Nursing Elites

1. A client has a new prescription for Hydrochlorothiazide. Which of the following adverse effects should the nurse monitor?

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

Correct answer: A

Rationale: Corrected Rationale: Hydrochlorothiazide, a diuretic, can lead to electrolyte imbalances, particularly hyponatremia (low sodium levels). The nurse should closely monitor the client's sodium levels due to the potential adverse effect of Hydrochlorothiazide. Incorrect Rationales: - Hyperkalemia (Choice B) is less likely to be caused by Hydrochlorothiazide; in fact, it can lead to hypokalemia. - Hypercalcemia (Choice C) is not a common adverse effect of Hydrochlorothiazide. - Hypoglycemia (Choice D) is not directly associated with Hydrochlorothiazide use.

2. A client has a prescription for Desmopressin for the treatment of Diabetes Insipidus. Which of the following instructions should the nurse include in the teaching?

• A. Decrease fluid intake at the start of treatment.
• B. Monitor for nocturia.
• C. Report a weight loss of 0.5 kg (1.1 lb) per week.
• D. Expect permanent polyuria with this medication.

Correct answer: A

Rationale: Desmopressin is a medication used to reduce diuresis in clients with diabetes insipidus. To prevent water intoxication, clients should be advised to decrease fluid intake at the beginning of treatment. This instruction helps to balance fluid levels in the body and prevent potential complications associated with excessive fluid intake while on Desmopressin therapy. Monitoring for signs of fluid retention, such as weight gain, and adjusting fluid intake accordingly are essential components of client education when initiating treatment with Desmopressin.

3. A client in a substance abuse clinic is being assessed by a nurse after discontinuing disulfiram due to severe nausea and vomiting. What is the likely cause of the client's distress?

• A. The client demonstrated an allergic response to the medication.
• B. The client experienced a common side effect of the medication.
• C. The client consumed alcohol while taking the medication.
• D. The client took an overdose of the medication.

Correct answer: C

Rationale: Disulfiram, when combined with alcohol, leads to a severe reaction causing nausea and vomiting. Since the client experienced these symptoms after starting disulfiram, it is likely that they consumed alcohol while taking the medication. Choice A is incorrect because the symptoms are more indicative of the interaction with alcohol rather than an allergic response. Choice B is incorrect as severe nausea and vomiting are not common side effects of disulfiram alone. Choice D is incorrect as there is no indication of an overdose based on the symptoms described.

4. In reviewing a client's health record, which condition would be a contraindication for using Propranolol to treat hypertension?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blocking beta2 receptors in the lungs can lead to bronchoconstriction, making it unsuitable for clients with asthma. Therefore, asthma is a contraindication for taking Propranolol. Glaucoma, hypertension, and tachycardia are not contraindications for using Propranolol to treat hypertension.

5. When administering medications to a 4-month-old infant, which of the following pharmacokinetic principles should be considered? (Select all that apply.)

• A. Infants have a more rapid gastric emptying time.
• B. Infants have immature liver function.
• C. Infants' blood-brain barrier is poorly developed.
• D. Infants have an increased ability to absorb topical medications.

Correct answer: B

Rationale: When administering medications to a 4-month-old infant, the pharmacokinetic principle to consider is that infants have immature liver function until 1 year of age. This requires medications metabolized by the liver to be administered in smaller dosages. While infants do have a more rapid gastric emptying time, immature liver function is a more critical pharmacokinetic consideration in this context. Additionally, although infants have a poorly developed blood-brain barrier, this relates more to pharmacodynamic effects rather than pharmacokinetic principles. The statement about infants having an increased ability to absorb topical medications is not directly related to pharmacokinetic principles, making choice B the correct answer.

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