Nursing Elites

1. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Dry cough.
• B. Hyperglycemia.
• C. Weight gain.
• D. Increased urination.

Correct answer: A

Rationale: The correct answer is A: Dry cough. A common adverse effect of Enalapril, an ACE inhibitor, is a persistent dry cough. This occurs due to the accumulation of bradykinin. It is essential for the client to monitor for this side effect and report it to their healthcare provider promptly. Choices B, C, and D are incorrect because hyperglycemia, weight gain, and increased urination are not typically associated with Enalapril use.

2. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?

• A. Spironolactone
• B. Furosemide
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: A

Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.

3. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.

4. A healthcare provider is reviewing the health history of a client who has a prescription for Propranolol. Which of the following findings should the provider report?

• A. Previous history of thromboembolism
• B. Concurrent use of an antacid
• C. History of bronchial asthma
• D. Recent weight gain

Correct answer: C

Rationale: Propranolol is a nonselective beta-blocker that can cause bronchoconstriction, making it contraindicated for clients with a history of bronchial asthma. Reporting a history of bronchial asthma to the provider is crucial as it would prompt a review of the medication prescription to avoid potential adverse effects and consider alternative treatment options.

5. A client has a new prescription for Warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, not potassium. Therefore, the client needs to be cautious with foods high in vitamin K, such as green leafy vegetables, rather than foods high in potassium. Choices A, B, and D are correct statements regarding Warfarin therapy and do not indicate a need for further teaching.

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