Nursing Elites

1. 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.

2. An adolescent client has a new prescription for Clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of this medication?

• A. Wear sunglasses when outdoors.
• B. Check your temperature daily.
• C. Take this medication in the morning.
• D. Add extra calories to your diet.

Correct answer: A

Rationale: To minimize the adverse effect of photophobia associated with Clomipramine, the client should be advised to wear sunglasses when outdoors. Clomipramine is a tricyclic antidepressant (TCA) known to cause anticholinergic effects like photophobia, which can be reduced by protecting the eyes with sunglasses when exposed to bright light. Choices B, C, and D are incorrect because checking temperature daily, taking the medication in the morning, and adding extra calories to the diet are not specifically related to minimizing the adverse effect of photophobia caused by Clomipramine.

3. A client has a new prescription for radioactive iodine to treat Hyperthyroidism. Which of the following instructions should the nurse include?

• A. Expect a metallic taste in the mouth.
• B. Avoid contact with pregnant women for 1 week.
• C. Administer iodine solution using a straw.
• D. Take thyroid replacement medication for 3 weeks after treatment.

Correct answer: B

Rationale: When a client undergoes radioactive iodine treatment for hyperthyroidism, they can emit radiation for a short time. To prevent radiation exposure to others, especially pregnant women, infants, and small children, clients should avoid close contact for about 1 week following therapy. This precaution is essential to protect vulnerable individuals from potential harm. Choice A is incorrect because a metallic taste in the mouth is not a common side effect of radioactive iodine treatment. Choice C is incorrect because administering iodine solution using a straw is not a standard practice in this treatment. Choice D is incorrect because taking thyroid replacement medication for 3 weeks after treatment is not a typical instruction associated with radioactive iodine therapy for hyperthyroidism.

4. The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?

• A. Atenolol (Tenormin)
• B. Nitroglycerin (Nitrostat)
• C. Sildenafil (Viagra)
• D. Ranolazine (Ranexa)

Correct answer: D

Rationale: In cases of chronic angina where initial treatment has not been successful, Ranolazine (Ranexa) is often prescribed. This medication helps by reducing the frequency of angina episodes. Atenolol, Nitroglycerin, and Sildenafil are also used in angina management but Ranolazine is more specifically indicated in cases of refractory angina where other treatments have failed.

5. A client who is receiving combination chemotherapy is exhibiting a temperature of 38.1°C (100.6°F). Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients undergoing chemotherapy due to the heightened risk of sepsis in immunocompromised individuals. Immediate assessment and intervention are crucial to prevent severe complications. Dry oral mucous membranes, nausea and vomiting, and anorexia are common side effects of chemotherapy but are not specific indicators of an oncologic emergency like a fever in this setting.

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