Nursing Elites

1. A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bed.
• B. Monitor for increased blood pressure.
• C. Take the medication on an empty stomach.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.

2. A client has a new prescription for Folic Acid. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication with food.
• B. I need to monitor for skin rash while taking this medication.
• C. I need to increase my intake of green, leafy vegetables.
• D. I will stop taking this medication if I feel nauseous.

Correct answer: C

Rationale: The correct answer is C. Folic acid is naturally found in green, leafy vegetables such as spinach and broccoli. Increasing the intake of these vegetables can supplement the prescribed folic acid and help maintain adequate levels in the body. It is essential to understand that dietary sources of folic acid can complement the medication and support overall health. Choices A, B, and D are incorrect because taking folic acid with food, monitoring for skin rash, or stopping the medication if feeling nauseous do not directly relate to enhancing the therapeutic effects of folic acid through dietary intake.

3. Which of the following is not an effect of the drug isoflurane?

• A. Elevated lipid levels
• B. Nausea
• C. Increased blood flow to the brain
• D. Decreased respiratory function

Correct answer: A

Rationale: Isoflurane is not known to cause elevated lipid levels. Common effects of isoflurane include nausea, increased blood flow to the brain, and decreased respiratory function. Elevated lipid levels are not typically associated with the administration of isoflurane, making choice A the correct answer.

4. A healthcare professional is reviewing the medical record of a client with a new prescription for Epoetin Alfa. Which of the following findings should the professional report to the provider?

• A. The client has a history of hypertension.
• B. The client has a hemoglobin level of 10 g/dL.
• C. The client has a history of chronic kidney disease.
• D. The client has a blood pressure of 140/90 mm Hg.

Correct answer: C

Rationale: The correct answer is C. Chronic kidney disease is a contraindication for the use of Epoetin Alfa because it can worsen hypertension, increase the risk of cardiovascular events, and lead to adverse outcomes. Epoetin Alfa is used to treat anemia by stimulating red blood cell production, but in the presence of chronic kidney disease, it can exacerbate hypertension and contribute to cardiovascular complications. Choices A, B, and D are not directly related to the contraindication of Epoetin Alfa in the presence of chronic kidney disease.

5. 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.

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