Nursing Elites

1. A client has a new prescription for furosemide. Which of the following statements should the nurse include in the teaching?

• A. This medication will increase your potassium levels.
• B. You should take this medication with food to prevent gastrointestinal upset.
• C. This medication will decrease your blood glucose levels.
• D. You should increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct statement the nurse should include in the teaching for a client with a new prescription for furosemide is that the client should take the medication with food to prevent gastrointestinal upset. Furosemide is a loop diuretic that can cause gastrointestinal upset, so taking it with food can help reduce this side effect and improve medication tolerance. Choices A, C, and D are incorrect because furosemide does not increase potassium levels, decrease blood glucose levels, or require an increase in the intake of potassium-rich foods. Therefore, the most important teaching point for the client is to take furosemide with food.

2. A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets. After securing the client's airway and initiating an IV, which of the following actions should the nurse do next?

• A. Monitor the client's IV site for thrombophlebitis.
• B. Administer flumazenil to the client.
• C. Evaluate the client for further suicidal behavior.
• D. Initiate seizure precautions for the client.

Correct answer: B

Rationale: Administering flumazenil is the priority to reverse the effects of diazepam overdose. Flumazenil is a specific benzodiazepine receptor antagonist that can rapidly reverse the sedative effects of diazepam. Monitoring the IV site for thrombophlebitis is important but not the immediate priority in this situation. Evaluating the client for further suicidal behavior is important for comprehensive care but is not the most urgent action at this moment. Initiating seizure precautions may be necessary, but the priority is to counteract the sedative effects of diazepam with flumazenil.

3. A nurse is reviewing the laboratory results of a client who is receiving warfarin therapy for atrial fibrillation. Which of the following laboratory values should the nurse report to the provider?

• A. INR 1.8
• B. Hemoglobin 14 g/dL
• C. Platelets 175,000/mm³
• D. Potassium 3.8 mEq/L

Correct answer: A

Rationale: The correct answer is A. An INR of 1.8 is below the therapeutic range for a client receiving warfarin, indicating a potential risk of blood clots. This value should be reported to the provider for further evaluation and possible adjustment of the warfarin dosage. Choices B, C, and D are within normal ranges and do not directly relate to the effectiveness or safety of warfarin therapy in this scenario, making them less urgent to report.

4. A client is being assessed in the PACU. Which of the following findings indicates decreased cardiac output?

• A. Shivering
• B. Oliguria
• C. Bradypnea
• D. Constricted pupils

Correct answer: B

Rationale: Oliguria is a sign of decreased cardiac output. Decreased cardiac output can lead to poor renal perfusion, resulting in decreased urine output (oliguria). This requires immediate intervention to improve cardiac function and perfusion. Shivering (Choice A) is a response to cold stress and does not directly indicate decreased cardiac output. Bradypnea (Choice C) refers to abnormally slow breathing rate and is more indicative of respiratory issues rather than decreased cardiac output. Constricted pupils (Choice D) are associated with the parasympathetic nervous system response and not directly related to cardiac output.

5. A nurse is reviewing the medical record of a client who is scheduled for surgery. Which of the following findings should the nurse report to the provider?

• A. Client reports taking warfarin
• B. Client has a history of hypertension
• C. Client ate a light breakfast 2 hours prior
• D. Client reports a history of smoking 10 cigarettes a day

Correct answer: A

Rationale: The correct answer is A. Warfarin is an anticoagulant that increases the risk of bleeding during surgery. It is crucial for the provider to be informed about the client taking warfarin to adjust the treatment plan accordingly. Choices B, C, and D are not as critical to report for surgical planning. A history of hypertension (B) is important but may not require immediate intervention for surgery. Eating a light breakfast 2 hours prior (C) is a normal preoperative instruction. Smoking history (D) is relevant for overall health assessment but is not as urgent as the use of warfarin before surgery.

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