Nursing Elites

1. A client has a new prescription for sertraline. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should take this medication at bedtime.
• B. I may experience sexual dysfunction.
• C. I should avoid drinking grapefruit juice.
• D. I may experience weight loss while taking this medication.

Correct answer: B

Rationale: The correct answer is B. Sexual dysfunction is a common side effect of sertraline. When the client mentions this potential side effect, it indicates an understanding of the teaching about the medication's effects. This response shows awareness of a significant adverse effect that the client should be informed about when starting sertraline. Choices A, C, and D are incorrect because taking sertraline at bedtime, avoiding grapefruit juice, or experiencing weight loss are not key teaching points associated with this medication.

2. A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. The nurse listens to breath sounds, expecting to hear which breath sounds bilaterally?

• A. Rhonchi
• B. Crackles
• C. Wheezes
• D. Diminished breath sounds

Correct answer: B

Rationale: In this scenario, the client is exhibiting signs of pulmonary edema, which can occur as a complication of myocardial infarction. Crackles are typically heard in cases of pulmonary edema, characterized by fluid accumulation in the lungs. These crackling sounds are heard during inspiration and sometimes expiration and are an indication of fluid-filled alveoli. Therefore, when assessing the client with these symptoms, the nurse would expect to hear crackles bilaterally. Rhonchi, which are coarse rattling respiratory sounds, are typically associated with conditions like bronchitis or pneumonia, not pulmonary edema. Wheezes are high-pitched musical sounds heard in conditions like asthma or COPD, not commonly present in pulmonary edema. Diminished breath sounds suggest decreased airflow or lung consolidation, not typical findings in pulmonary edema.

3. A client with heart failure is prescribed furosemide (Lasix). The nurse should monitor the client for which potential electrolyte imbalance?

• A. Hyperkalemia
• B. Hypernatremia
• C. Hypokalemia
• D. Hypocalcemia

Correct answer: C

Rationale: When a client with heart failure is prescribed furosemide, the nurse should monitor for hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, which increases the risk of hypokalemia. Hypokalemia can have serious implications such as cardiac dysrhythmias. Therefore, it is essential to closely monitor the client's serum potassium levels while on furosemide to prevent complications. Hyperkalemia (Choice A) is incorrect because furosemide leads to potassium loss, not retention. Hypernatremia (Choice B) is not typically associated with furosemide use. Hypocalcemia (Choice D) is not a common electrolyte imbalance caused by furosemide.

4. A client with chronic stable angina is prescribed nitroglycerin (Nitrostat) for chest pain. The nurse should include which instruction when teaching the client about this medication?

• A. Take nitroglycerin at the first sign of chest pain.
• B. Swallow the tablet whole with water.
• C. Take nitroglycerin with meals to prevent stomach upset.
• D. Store nitroglycerin in a cool, dry place.

Correct answer: A

Rationale: The correct instruction when teaching a client about nitroglycerin (Nitrostat) is to take it at the first sign of chest pain. Nitroglycerin works rapidly to dilate blood vessels, improving blood flow to the heart muscle. Taking it promptly can help alleviate symptoms quickly and prevent the condition from worsening. Choice B is incorrect because nitroglycerin is usually taken sublingually (under the tongue) and not swallowed. Choice C is incorrect because nitroglycerin is not typically taken with meals. Choice D is incorrect because nitroglycerin should be stored in its original container away from heat and light.

5. A client has a new prescription for amlodipine. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor blood pressure daily.
• C. Increase intake of potassium-rich foods.
• D. Avoid consuming grapefruit juice.

Correct answer: B

Rationale: The correct answer is B: 'Monitor blood pressure daily.' When a client is prescribed amlodipine, it is essential to monitor their blood pressure regularly. Amlodipine is known to cause hypotension, so monitoring blood pressure helps ensure it stays within the desired range to prevent complications associated with low blood pressure. Choice A is incorrect because amlodipine can be taken with or without food. Choice C is incorrect as increasing potassium intake is not a specific instruction related to amlodipine. Choice D is incorrect as grapefruit juice interactions are not typically a concern with amlodipine.

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