Nursing Elites

1. When reviewing a client's health record, a healthcare professional notes that the client is experiencing episodes of hypokalemia. Which of the following medications should be identified as a cause of the client's hypokalemia?

• A. Captopril
• B. Lisinopril
• C. Furosemide
• D. Spironolactone

Correct answer: C

Rationale: Furosemide, a loop diuretic, can lead to hypokalemia by increasing the excretion of potassium in the urine. This potassium loss can result in lower-than-normal levels of potassium in the body, leading to hypokalemia.

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

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

Correct answer: A

Rationale: Corrected Rationale: Enalapril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. The nurse should closely monitor the client for this and instruct them to report it to the healthcare provider if it occurs. Choices B, C, and D are incorrect as weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

3. A female client with tobacco use disorder is being educated by a nurse about Nicotine replacement therapy. Which of the following statements by the client shows understanding of the teaching?

• A. I should avoid eating right before I chew a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking if I become pregnant.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. The client should avoid eating or drinking 15 minutes prior to and while chewing the nicotine gum. Choice B is incorrect because there is no specified timeline for stopping nicotine gum use. Choice C is incorrect because nicotine gum is not recommended during pregnancy. Choice D is incorrect as the client should chew the nicotine gum slowly for about 30 minutes, not quickly for 15 minutes.

4. A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.

5. A client is receiving treatment with methotrexate. Which of the following supplements should the nurse instruct the client to take?

• A. Folic acid
• B. Vitamin D
• C. Calcium
• D. Iron

Correct answer: A

Rationale: The nurse should instruct the client to take folic acid when receiving treatment with methotrexate to reduce the risk of methotrexate toxicity. Methotrexate acts as a folic acid antagonist, leading to folic acid deficiency, which can be counteracted by supplementing with folic acid. Vitamin D, calcium, and iron are not specifically recommended to counteract methotrexate effects and do not play a significant role in mitigating methotrexate toxicity.

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