Nursing Elites

1. When teaching a client about the use of lisinopril, which of the following should be included?

• A. It can cause a persistent cough
• B. It is a calcium channel blocker
• C. It is safe during pregnancy
• D. It should be taken with food

Correct answer: A

Rationale: The correct answer is A. Lisinopril is an ACE inhibitor, and a common side effect associated with its use is a persistent cough. This is important information that the client should be aware of. Choice B is incorrect because lisinopril is not a calcium channel blocker, it is an ACE inhibitor. Choice C is incorrect as lisinopril is not considered safe during pregnancy, especially during the second and third trimesters as it can cause harm to the fetus. Choice D is incorrect because lisinopril is typically recommended to be taken on an empty stomach, about an hour before meals.

2. A client has been taking propranolol. Which of the following findings indicates a need to withhold the medication?

• A. Sodium 130 mEq/L
• B. Blood pressure 156/90 mm Hg
• C. Potassium 5.2 mEq/L
• D. Pulse 54/min

Correct answer: D

Rationale: A pulse of 54/min indicates bradycardia, which is a side effect of propranolol, a beta-blocker. The medication should be withheld if the client's pulse drops below 60/min. The other findings (sodium levels, blood pressure, and potassium levels) are not directly indicative of the need to withhold propranolol.

3. A nurse is assessing a client with chronic kidney disease. Which of the following should the nurse monitor for?

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

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Clients with chronic kidney disease are at risk for hyperkalemia due to impaired potassium excretion. In chronic kidney disease, the kidneys are unable to effectively excrete potassium, leading to its accumulation in the blood. Hypercalcemia (Choice B) is not typically associated with chronic kidney disease. Hypoglycemia (Choice C) refers to low blood sugar levels and is not directly related to chronic kidney disease. Hyponatremia (Choice D) is a condition characterized by low sodium levels and is not a typical concern in chronic kidney disease.

4. A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. How many mL should the nurse administer per dose? (Round to the nearest tenth)

• A. 2.6 mL
• B. 2.2 mL
• C. 3.5 mL
• D. 5.0 mL

Correct answer: A

Rationale: The correct calculation is as follows: The toddler's weight in kg is 13 kg (28.6 lb / 2.2 lb/kg). The total daily dose is 260 mg (20 mg x 13 kg). Therefore, the dose per administration is 130 mg (260 mg / 2). Given the concentration of 250 mg/5 mL, the dose in mL is 2.6 mL (130 mg / (250 mg/5 mL)). Therefore, the nurse should administer 2.6 mL per dose. Choice B, 2.2 mL, is incorrect as it does not reflect the correct calculation. Choices C and D, 3.5 mL and 5.0 mL, are also incorrect and do not align with the accurate dosage calculation based on the given scenario.

5. A client with chronic kidney disease is being educated by a nurse about managing their condition. Which of the following statements shows an understanding of the teaching?

• A. I will need to take an iron supplement.
• B. I will consume foods high in phosphorus.
• C. I will reduce my intake of carbohydrates.
• D. I will monitor my blood glucose level daily.

Correct answer: A

Rationale: The correct answer is A. Clients with chronic kidney disease often develop anemia due to reduced erythropoietin production, leading to decreased red blood cell production. Iron supplementation is frequently required to enhance red blood cell production. Choices B, C, and D are incorrect because in chronic kidney disease, there is a need to restrict phosphorus intake, control carbohydrate intake for blood sugar management, and monitor electrolytes and fluid balance rather than blood glucose levels.

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