Nursing Elites

1. A patient is receiving spironolactone for heart failure. Which of the following findings should the nurse report to the provider?

• A. Hyperkalemia
• B. Hypernatremia
• C. Hyponatremia
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia due to its mechanism of action. Hyperkalemia, or elevated potassium levels, can result in serious cardiac complications and requires immediate medical attention. Therefore, the nurse should promptly report any signs or symptoms of hyperkalemia to prevent potential adverse outcomes in the patient. Choices B, C, and D are incorrect because spironolactone is not associated with hypernatremia, hyponatremia, or hypokalemia. Hyperkalemia is the critical finding that the nurse should report in a patient receiving spironolactone.

2. A client has a new prescription for Sulfasalazine for the treatment of Crohn's disease. Which of the following instructions should the nurse include?

• A. Expect orange-yellow discoloration of urine and skin.
• B. Take the medication with food.
• C. Do not discontinue the medication if a sore throat occurs.
• D. Avoid prolonged exposure to sunlight.

Correct answer: A

Rationale: The correct answer is A: 'Expect orange-yellow discoloration of urine and skin.' Sulfasalazine can cause this harmless side effect, which does not require discontinuation of the medication. Option B is incorrect because Sulfasalazine is usually taken with food to minimize gastrointestinal side effects. Option C is incorrect as a sore throat is not a common reason to stop the medication. Option D is not directly related to the side effects of Sulfasalazine.

3. A client is starting therapy with topotecan. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of topotecan. Monitoring for signs of infection is crucial to prevent complications during therapy. Choices A, B, and D are less critical findings compared to a sore throat. Hair loss is a common side effect of chemotherapy, fatigue is expected with cancer treatment, and red urine is a known harmless effect of topotecan.

4. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital, with a long half-life of 4 days, remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should administer phenobarbital once a day to maintain a consistent therapeutic effect without the need for multiple daily doses. Administering the medication more than once a day would not be necessary and could increase the risk of side effects or toxicity. Therefore, the correct answer is to administer phenobarbital once a day.

5. What is the correct medical term used to describe impaired blood flow in the coronary arteries?

• A. Myocardial infarction
• B. Angina pectoris
• C. Cerebrovascular accident
• D. Coronary heart disease

Correct answer: D

Rationale: The correct medical term for impaired blood flow in the coronary arteries is Coronary heart disease. This condition is characterized by a narrowing or blockage of the coronary arteries, leading to reduced blood flow to the heart muscle. Myocardial infarction (choice A) refers to a heart attack, which occurs when blood flow to a part of the heart is blocked. Angina pectoris (choice B) is chest pain or discomfort that occurs when the heart muscle doesn't receive enough oxygen-rich blood. Cerebrovascular accident (choice C) is the medical term for a stroke, which occurs when blood flow to a part of the brain is interrupted.

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