Nursing Elites

1. A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

2. When educating a client with a new prescription for Losartan, which instruction should the nurse provide?

• A. Avoid consuming grapefruit juice.
• B. Take this medication with a full glass of water.
• C. Take this medication with food.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct answer is to instruct the client to monitor for signs of dehydration when taking Losartan. Losartan can lead to dehydration, so it is crucial for the client to watch out for symptoms like dry mouth, increased thirst, and reduced urine output. Monitoring for these signs can help prevent complications associated with dehydration while taking this medication. Choices A, B, and C are incorrect because Losartan is not known to have interactions with grapefruit juice, does not require a specific amount of water for intake, and can be taken with or without food.

3. A client is taking Epoetin Alfa for anemia. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. White blood cell count
• B. Platelet count
• C. Hematocrit
• D. Serum potassium level

Correct answer: C

Rationale: The nurse should monitor the hematocrit level to evaluate the effectiveness of Epoetin Alfa therapy since it stimulates red blood cell production. Hematocrit reflects the volume of red blood cells in the blood, providing a direct measure of the therapy's impact on increasing red blood cell mass and addressing anemia. Monitoring white blood cell count and platelet count is not directly related to assessing the effectiveness of Epoetin Alfa therapy for anemia. Serum potassium level monitoring may be necessary due to potential side effects of the medication, but it is not the primary indicator of therapy effectiveness in treating anemia.

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

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect decreased urination within the first few days.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Hydrochlorothiazide is a diuretic that can lead to hypokalemia by increasing potassium excretion. Therefore, instructing the client to increase their intake of potassium-rich foods is essential to prevent electrolyte imbalances and support overall health. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning is not directly related to the medication's mechanism of action. Expecting decreased urination within the first few days is not accurate as the medication is a diuretic that typically increases urination. Also, advising the client to avoid foods high in potassium would not be suitable, as increasing potassium-rich foods is necessary to counteract potential potassium depletion caused by Hydrochlorothiazide.

5. A nurse is caring for a client who has a new prescription for Metformin. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid eating foods high in potassium.
• C. Take this medication at bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: The correct instruction for a client prescribed Metformin is to take the medication with food. Taking Metformin with meals helps reduce gastrointestinal side effects and ensures better absorption. Choice B, to avoid foods high in potassium, is not directly related to Metformin. Choice C, taking the medication at bedtime, is not a standard instruction for Metformin. Choice D, taking the medication every other day, is incorrect as Metformin is typically taken daily as prescribed.

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