Nursing Elites

1. A client with chronic renal disease is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

• A. The leukocyte count
• B. The platelet count
• C. The hematocrit (Hct)
• D. The erythrocyte sedimentation rate (ESR)

Correct answer: C

Rationale: The correct answer is C: The hematocrit (Hct). Monitoring the hematocrit is essential to assess the therapeutic effect of epoetin alfa because this medication stimulates red blood cell production in clients with chronic renal disease. The leukocyte count (choice A) and platelet count (choice B) are not directly affected by epoetin alfa therapy. The erythrocyte sedimentation rate (ESR) (choice D) is a non-specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa.

2. A client is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

• A. Decreased blood pressure
• B. Increase in HDL cholesterol
• C. Prevention of bipolar manic episodes
• D. Improved sexual function

Correct answer: A

Rationale: The therapeutic effect of lisinopril, an ACE inhibitor, is indicated by a decrease in blood pressure. Lisinopril works by relaxing blood vessels, leading to a reduction in blood pressure. Monitoring and achieving a decrease in blood pressure is a key outcome when managing hypertension with lisinopril. Choices B, C, and D are incorrect because lisinopril is not intended to increase HDL cholesterol, prevent bipolar manic episodes, or improve sexual function. Therefore, the correct outcome indicating the therapeutic effect of lisinopril is a decrease in blood pressure.

3. A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Dry mouth
• C. Insomnia
• D. Hypertension

Correct answer: B

Rationale: Dry mouth is a common adverse effect associated with clonidine use. Clonidine is known to cause xerostomia (dry mouth) due to its effect on reducing salivary flow. Monitoring for dry mouth is important as it can lead to oral health issues and discomfort for the client. Diarrhea, insomnia, and hypertension are not typically associated with clonidine use, making them less likely adverse effects to monitor for in this scenario.

4. A client with early Parkinson's disease has been prescribed pramipexole. What adverse effect should the nurse instruct the client to monitor for?

• A. Hallucinations
• B. Increased salivation
• C. Diarrhea
• D. Discoloration of urine

Correct answer: A

Rationale: The correct answer is A: Hallucinations. Pramipexole can lead to hallucinations within 9 months of the initial dose, which may necessitate discontinuation of the medication. Monitoring for hallucinations is crucial to ensure early detection and management to prevent any adverse outcomes. Choice B, increased salivation, is not a common adverse effect of pramipexole. Choice C, diarrhea, is not typically associated with pramipexole use. Choice D, discoloration of urine, is not a known adverse effect of pramipexole and is not typically a concern with this medication.

5. When a client has a new prescription for Warfarin, which of the following foods should they avoid based on the nurse's instructions?

• A. Broccoli
• B. Bananas
• C. Chicken
• D. Potatoes

Correct answer: A

Rationale: Clients prescribed Warfarin should avoid foods high in vitamin K, like broccoli, as they can counteract the medication's effectiveness. Warfarin works by inhibiting vitamin K-dependent clotting factors, so consuming high vitamin K foods can interfere with its anticoagulant effects. Bananas, chicken, and potatoes are not high in vitamin K and do not have a significant impact on Warfarin therapy.

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