Nursing Elites

1. A healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. This cough is a result of increased bradykinin levels due to ACE inhibition. The client should be educated to monitor for a dry cough and notify the healthcare provider if it occurs, as it may indicate the need for a medication adjustment. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

2. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

• A. Increased renal secretion
• B. Increased medication-metabolizing enzymes
• C. Liver failure
• D. Peripheral vascular disease

Correct answer: C

Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.

3. When taking Digoxin, low levels of what can cause toxicity?

• A. Potassium
• B. Calcium
• C. Sodium
• D. Magnesium

Correct answer: A

Rationale: Low potassium levels can lead to Digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium pump. When potassium levels are low, there is an increased risk of Digoxin binding and toxicity. Choice B (Calcium) is incorrect because low calcium levels are not directly linked to Digoxin toxicity. Choice C (Sodium) is incorrect as low sodium levels do not cause Digoxin toxicity. Choice D (Magnesium) is incorrect as low magnesium levels do not contribute to Digoxin toxicity.

4. A client has a new prescription for Verapamil to treat angina. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of Verapamil?

• A. I am constipated frequently.
• B. I have been urinating more frequently.
• C. My skin is peeling.
• D. I have ringing in my ears.

Correct answer: A

Rationale: Constipation is a common adverse effect of Verapamil, a calcium channel blocker. Verapamil can slow down bowel movements and lead to constipation as a side effect. Therefore, the client reporting frequent constipation should alert the nurse to a potential adverse effect of Verapamil. Choices B, C, and D are not typically associated with Verapamil use. Increased urination is not a common side effect of Verapamil, peeling skin is more likely related to a dermatological issue, and ringing in the ears is not a known adverse effect of Verapamil.

5. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV Nitroprusside is infused at high dosages, it can lead to thiocyanate toxicity, causing mental status changes such as delirium. It is crucial to monitor the thiocyanate levels to ensure they remain below 10 mg/dL during therapy to prevent adverse effects. Choices A, B, and D are incorrect because IV Nitroprusside is not commonly associated with intestinal ileus, neutropenia, or hyperthermia. Monitoring for delirium is crucial due to the risk of thiocyanate toxicity.

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