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. 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.

3. A client is receiving spironolactone. Which of the following findings should the nurse report to the provider?

• A. Serum Sodium 144 mEq/L
• B. Urine output 120 mL in 4 hrs
• C. Serum Potassium 5.2 mEq/L
• D. Blood Pressure 140/90 mmHg

Correct answer: C

Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to potassium retention. The nurse should notify the provider and withhold the medication to prevent further elevation of potassium levels, which can result in serious cardiac complications. The other findings (Serum Sodium 144 mEq/L, Urine output 120 mL in 4 hrs, and Blood Pressure 140/90 mmHg) are within normal ranges and not directly related to spironolactone therapy.

4. A client has ordered a thrombolytic medication for the treatment of CVA. Which type of stroke should not be treated with a thrombolytic?

• A. Hemorrhagic stroke
• B. Thrombotic stroke
• C. Both types can be treated with a thrombolytic
• D. Neither type can be treated with a thrombolytic

Correct answer: A

Rationale: Thrombolytic medications are used to dissolve blood clots. In the case of a hemorrhagic stroke, where there is bleeding in the brain, the use of thrombolytics can worsen the condition by increasing bleeding. Therefore, hemorrhagic strokes should not be treated with thrombolytic medications.

5. A client has a new prescription for Furosemide. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypernatremia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Furosemide, a diuretic, commonly causes hyponatremia (low sodium levels) as it increases the excretion of sodium. The nurse needs to monitor the client for signs of hyponatremia, such as confusion, weakness, and muscle cramps, by checking electrolyte levels regularly. Choices A, C, and D are incorrect because hyperkalemia (choice A), hypernatremia (choice C), and hypercalcemia (choice D) are not typically associated with Furosemide use.

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