Nursing Elites

1. A client is prescribed Propylthiouracil (PTU) for the treatment of Graves' disease. Which adverse effect should the client be instructed to report?

• A. Sore throat.
• B. Drowsiness.
• C. Urinary retention.
• D. Heat intolerance.

Correct answer: A

Rationale: The correct answer is A: Sore throat. A sore throat and fever can indicate agranulocytosis, a serious adverse effect of PTU that can lead to a decreased white blood cell count. This condition requires immediate medical attention to prevent complications. Choice B, drowsiness, is not typically associated with PTU and is not a common adverse effect that needs to be reported. Choice C, urinary retention, is not a typical adverse effect of PTU; therefore, it is not the correct answer. Choice D, heat intolerance, is a symptom commonly seen in hyperthyroidism, which PTU is used to treat, so it is not an adverse effect that needs to be specifically reported.

2. When teaching a client with a prescription for long-term use of oral prednisone for chronic asthma, the nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: The correct answer is weight gain. Weight gain and fluid retention are common adverse effects of oral prednisone due to sodium and water retention. Patients on long-term prednisone therapy should be advised to monitor their weight closely and report any significant changes to their healthcare provider. Choice B, 'Nervousness,' is not typically associated with oral prednisone use. Choice C, 'Bradycardia,' refers to a slow heart rate, which is not a common adverse effect of prednisone. Choice D, 'Constipation,' is not a typical adverse effect of oral prednisone; instead, gastrointestinal disturbances like increased appetite or even peptic ulcer disease may occur.

3. Potassium-sparing diuretics primarily affect which part of the kidney?

• A. Proximal convoluted tubule
• B. Loop of Henle
• C. Collecting duct
• D. Distal convoluted tubule

Correct answer: D

Rationale: Potassium-sparing diuretics exert their primary effects on the distal convoluted tubule in the kidney. By acting on this specific part of the nephron, these diuretics promote sodium excretion while sparing potassium, thus helping to maintain potassium levels in the body. This mechanism differs from other diuretics that may cause potassium loss as a side effect. Understanding the site of action of potassium-sparing diuretics is crucial in clinical practice for managing conditions like hypertension and edema where diuresis is necessary without the risk of hypokalemia.

4. When starting therapy with Lisinopril, a client should be instructed to monitor for which of the following adverse effects?

• A. Tinnitus
• B. Diarrhea
• C. Cough
• D. Weight gain

Correct answer: C

Rationale: When starting therapy with Lisinopril, a client should be instructed to monitor for a persistent dry cough as an adverse effect. Lisinopril, an ACE inhibitor, commonly causes this cough as an adverse effect. It is important for the client to monitor for this symptom and notify their healthcare provider if it occurs. Choices A, B, and D are incorrect because tinnitus, diarrhea, and weight gain are not commonly associated adverse effects of Lisinopril.

5. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

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