Nursing Elites

1. A client receives a local anesthetic of Lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client?

• A. Seizures
• B. Tachycardia
• C. Hypertension
• D. Fever

Correct answer: A

Rationale: Seizures are a potential adverse reaction to local anesthetics like Lidocaine. Lidocaine can affect the central nervous system and, in some cases, lead to seizure activity. Therefore, it is important for the nurse to monitor the client for any signs of seizures during and after the administration of Lidocaine.

2. When teaching a client with a new prescription for Lisinopril, which instruction should the nurse include?

• A. Take the medication with food.
• B. Expect a persistent, dry cough.
• C. Increase your intake of potassium-rich foods.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is B: 'Expect a persistent, dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent, dry cough as a side effect. This should be reported to the healthcare provider if it becomes bothersome. It is essential for the nurse to educate the client about this potential side effect so the client is aware and can seek appropriate guidance if needed. Choices A, C, and D are incorrect. Taking Lisinopril with food is not required. Increasing potassium-rich foods is not a specific instruction for Lisinopril, and taking the medication at bedtime is not a typical recommendation associated with this medication.

3. A client has a new prescription for Warfarin. Which of the following herbal supplements should the client be instructed to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by affecting its metabolism. Echinacea, garlic, and ginseng are also known to interact with Warfarin, either by increasing the risk of bleeding or altering its anticoagulant effects. However, St. John's wort is particularly significant due to its potent enzyme-inducing properties that can lead to subtherapeutic levels of Warfarin, potentially increasing the risk of blood clots.

4. A client has a prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take furosemide in the morning.
• B. Eat a diet high in potassium.
• C. Avoid foods high in magnesium.
• D. Limit fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct instruction for a client taking furosemide is to eat a diet high in potassium. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Consuming foods rich in potassium can help maintain normal potassium levels in the body and counteract the potential side effect of furosemide. Choices A, C, and D are incorrect because taking furosemide in the morning does not specifically relate to its effectiveness or side effects, avoiding foods high in magnesium is not a primary concern when taking furosemide, and limiting fluid intake to 1 liter per day is not a general recommendation for individuals taking furosemide.

5. A healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?

• A. Warfarin
• B. Acetaminophen
• C. Ibuprofen
• D. Aspirin

Correct answer: D

Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.

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