Nursing Elites

1. A client has a new prescription for metformin. Which of the following statements should the nurse include in the teaching?

• A. Take the medication with a full glass of water.
• B. Monitor for signs of hypoglycemia.
• C. Increase your fluid intake.
• D. Expect a metallic taste in your mouth.

Correct answer: C

Rationale: Increasing fluid intake is an important teaching point for clients starting metformin to prevent gastrointestinal discomfort, a common side effect of this medication. Metformin can cause gastrointestinal symptoms such as nausea, bloating, and diarrhea, which can be reduced by staying well-hydrated. Therefore, advising the client to increase their fluid intake will help minimize these side effects and improve medication tolerance. The other options are incorrect: Option A is a general instruction for taking medications but not specifically related to metformin. Option B is incorrect because metformin typically does not cause hypoglycemia but rather hyperglycemia. Option D is also incorrect as a metallic taste in the mouth is not a common side effect of metformin.

2. The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which intervention should the nurse implement when providing care for the client?

• A. Take daily weights and monitor trends.
• B. Encourage fluid intake to improve hydration.
• C. Elevate the legs above the level of the heart.
• D. Position the client supine with the head of the bed at 30 degrees.

Correct answer: A

Rationale: Elevated BNP levels are indicative of heart failure, which often causes fluid retention and weight gain. Taking daily weights and monitoring trends allows the nurse to assess for changes in fluid status. This intervention helps in evaluating the effectiveness of the treatment plan and identifying worsening heart failure symptoms early. Encouraging fluid intake (Choice B) might exacerbate fluid overload in a client with elevated BNP levels. Elevating the legs (Choice C) and positioning the client supine with the head of the bed at 30 degrees (Choice D) are interventions more suitable for clients with hypotension, not specifically indicated for managing elevated BNP levels.

3. A client has a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take the medication with or without food.
• B. Monitor for signs of hypokalemia.
• C. Increase your intake of potassium-rich foods.
• D. Expect an increase in urination.

Correct answer: D

Rationale: The correct instruction to include when a client is prescribed furosemide is to expect an increase in urination. Furosemide is a diuretic that works by increasing urine production, so it is essential for the client to anticipate and understand this effect. Monitoring for signs of hypokalemia and increasing potassium-rich foods are not directly related to furosemide use. Hypokalemia is a potential side effect of furosemide, so monitoring for it is crucial. Increasing potassium-rich foods can help counteract potassium loss due to diuretic use. Taking furosemide with food is not required, as it can be taken with or without food.

4. A healthcare provider is assessing a client who has been taking lisinopril. Which of the following findings should the provider report?

• A. Dry cough
• B. Hyperkalemia
• C. Elevated blood pressure
• D. Increased appetite

Correct answer: A

Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of lisinopril. It is essential to report this to the healthcare provider as it may indicate the need to discontinue the medication to prevent further complications such as angioedema or cough that can persist for weeks to months after stopping the medication. Choice B, hyperkalemia, is not typically associated with lisinopril use; instead, it is a possible side effect of medications like potassium-sparing diuretics. Choice C, elevated blood pressure, would not be a concerning finding as lisinopril is often prescribed to lower blood pressure. Choice D, increased appetite, is not a common side effect of lisinopril and would not typically warrant immediate reporting.

5. The nurse is preparing to care for a client who will be arriving from the recovery room after an above-the-knee amputation. The nurse ensures that which priority item is available for emergency use?

• A. Surgical tourniquet
• B. Dry sterile dressings
• C. Incentive spirometer
• D. Over-the-bed trapeze

Correct answer: A

Rationale: In the case of an above-the-knee amputation, the priority item that should be available for emergency use is a surgical tourniquet. This is crucial to control severe bleeding that may occur post-operatively. Dry sterile dressings (choice B) are important for wound care but not for immediate post-operative emergencies like bleeding. An incentive spirometer (choice C) is used for respiratory exercises and not directly related to emergency management post-amputation. An over-the-bed trapeze (choice D) is used for assisting clients with mobility and positioning, not for emergency situations involving bleeding.

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