Nursing Elites

1. A client is taking Furosemide for heart failure. Which of the following laboratory tests should the nurse monitor to assess for an adverse effect of this medication?

• A. Serum potassium.
• B. Serum calcium.
• C. Serum sodium.
• D. Serum magnesium.

Correct answer: A

Rationale: Furosemide, a loop diuretic commonly used in heart failure, can cause hypokalemia (low potassium levels) as a side effect. Monitoring serum potassium levels is crucial to detect and prevent complications associated with low potassium levels, such as cardiac arrhythmias. Therefore, the nurse should prioritize assessing the client's serum potassium levels regularly while on Furosemide. Serum calcium, sodium, and magnesium levels are not typically affected by Furosemide and are not the primary focus of monitoring for adverse effects of this medication.

2. A client is to receive Tetracaine before a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?

• A. Keep the client NPO until the pharyngeal response returns.
• B. Monitor the insertion site for a hematoma.
• C. Palpate the bladder to detect urinary retention.
• D. Maintain the client on bed rest for 12 hours following the procedure.

Correct answer: A

Rationale: The correct action for the nurse to include in the plan of care is to keep the client NPO until the pharyngeal response returns. Tetracaine can affect the gag reflex, so it is important to prevent aspiration by maintaining the client NPO until the pharyngeal response is normal, which typically takes about 1 hour. Monitoring for the return of the gag reflex is crucial to prevent complications from aspiration during the first oral intake after the procedure. Choices B, C, and D are incorrect because they are not directly related to the effects of Tetracaine or the bronchoscopy procedure.

3. A client has a prescription for Desmopressin for the treatment of Diabetes Insipidus. Which of the following instructions should the nurse include in the teaching?

• A. Decrease fluid intake at the start of treatment.
• B. Monitor for nocturia.
• C. Report a weight loss of 0.5 kg (1.1 lb) per week.
• D. Expect permanent polyuria with this medication.

Correct answer: A

Rationale: Desmopressin is a medication used to reduce diuresis in clients with diabetes insipidus. To prevent water intoxication, clients should be advised to decrease fluid intake at the beginning of treatment. This instruction helps to balance fluid levels in the body and prevent potential complications associated with excessive fluid intake while on Desmopressin therapy. Monitoring for signs of fluid retention, such as weight gain, and adjusting fluid intake accordingly are essential components of client education when initiating treatment with Desmopressin.

4. A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This situation can result in increased drug levels in the body, causing drowsiness and other side effects. Adjusting the dosage of the hypnotic medication may be necessary to prevent such adverse effects in older adult clients. Choice A, reduced cardiac function, is not directly related to the metabolism of the medication and is unlikely to cause drowsiness. Choice B, first-pass effect, refers to the initial metabolism of a drug in the liver before it enters circulation, but it is not the cause of drowsiness in this scenario. Choice D, increased gastric motility, does not play a significant role in the metabolism of the medication and is not a likely cause of the client's drowsiness.

5. A client has a new prescription for Nifedipine. Which of the following adverse effects should the nurse monitor?

• A. Hypertension
• B. Edema
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: Nifedipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should monitor the client for swelling in the lower extremities, as it indicates the onset of edema. Hypertension is typically treated with Nifedipine and is not an adverse effect of the medication. Hyperglycemia and bradycardia are not commonly associated with Nifedipine use. Therefore, the correct adverse effect to monitor for when a client is prescribed Nifedipine is edema.

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