Nursing Elites

1. A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?

• A. BUN
• B. Creatinine
• C. Hemoglobin
• D. White blood cell count

Correct answer: B

Rationale: Corrected Rationale: Creatinine levels should be monitored to evaluate vancomycin's effect on kidney function. Vancomycin can be nephrotoxic, so monitoring creatinine levels helps assess renal function and ensure that the medication is not causing harm to the kidneys. Monitoring BUN (choice A) is important for assessing kidney function but is not as specific as monitoring creatinine levels. Hemoglobin (choice C) and white blood cell count (choice D) are not directly related to evaluating the therapeutic effect of vancomycin.

2. A client is being discharged with a new prescription for Atenolol. Which of the following instructions should the nurse include?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid consuming foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B: 'Monitor your heart rate regularly.' Atenolol is a beta-blocker that can cause bradycardia (slow heart rate). Monitoring the heart rate regularly is crucial to promptly detect any significant decreases. This allows for timely intervention and adjustment of the medication regimen if needed, helping to prevent adverse effects associated with bradycardia. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning does not address the need for heart rate monitoring. Avoiding foods high in potassium is more relevant for medications like ACE inhibitors or potassium-sparing diuretics. Increasing fluid intake is not directly related to the use of Atenolol.

3. A client has a new prescription for hydrochlorothiazide to treat hypertension. Which of the following instructions should be included?

• A. Take the medication in the morning.
• B. Increase intake of potassium-rich foods.
• C. Avoid sun exposure while taking this medication.
• D. Limit fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct instruction that should be included for a client prescribed hydrochlorothiazide is to increase the intake of potassium-rich foods. Hydrochlorothiazide, being a diuretic, can lead to hypokalemia by enhancing potassium excretion. Increasing consumption of potassium-rich foods like bananas or oranges can help prevent hypokalemia and maintain electrolyte balance. Choices A, C, and D are incorrect. Taking the medication in the morning is not a specific instruction related to hydrochlorothiazide. Avoiding sun exposure is more relevant for photosensitive medications, not hydrochlorothiazide. Limiting fluid intake to 1 liter per day is not necessary unless specifically advised by a healthcare provider.

4. A healthcare provider is caring for four clients who have Peptic Ulcer Disease. The healthcare provider should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy due to its potential to induce labor. It is used to prevent ulcers in patients taking nonsteroidal anti-inflammatory drugs and is not indicated for osteoarthritis, kidney stones, or urinary tract infections. Therefore, the correct answer is A. Misoprostol should not be used in pregnant individuals as it can cause uterine contractions and potentially harm the fetus. Choices B, C, and D are incorrect as Misoprostol is not contraindicated for clients with osteoarthritis, kidney stones, or urinary tract infections.

5. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. It is characterized by a decreased level of neutrophils, which are important in fighting infections. Monitoring the client's complete blood count (CBC) is crucial to detect neutropenia early. The nurse should also educate the client on recognizing signs of infection and promptly reporting them to the healthcare provider for timely intervention. Hypokalemia is a potential adverse effect of diuretics, not ACE inhibitors. Hypernatremia is an electrolyte imbalance more commonly associated with conditions like dehydration. Bradycardia is not a typical adverse effect of Captopril.

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