Nursing Elites

1. A client has been prescribed an ACE Inhibitor for hypertension. Which of the following instructions should be included by the healthcare provider?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Avoid foods high in potassium.
• D. Limit your fluid intake.

Correct answer: A

Rationale: The correct answer is to 'Avoid salt substitutes.' ACE Inhibitors can increase potassium levels, so clients should avoid salt substitutes that contain potassium to prevent hyperkalemia, which is a potential side effect of ACE Inhibitors. Choice B 'Take this medication at bedtime' is incorrect as ACE Inhibitors are usually taken in the morning to avoid nocturnal diuresis. Choice C 'Avoid foods high in potassium' is incorrect because although ACE Inhibitors can increase potassium levels, clients are generally encouraged to consume potassium-rich foods in moderation unless contraindicated. Choice D 'Limit your fluid intake' is also incorrect as ACE Inhibitors do not typically require fluid restrictions unless specified by a healthcare provider for other reasons.

2. A client has a new prescription for Metformin to treat type 2 diabetes. Which of the following laboratory results should be monitored?

• A. Hemoglobin A1C
• B. Liver function tests
• C. Electrolyte levels
• D. Kidney function

Correct answer: D

Rationale: Metformin is excreted by the kidneys, and impaired kidney function can lead to an increased risk of lactic acidosis, a serious side effect. Therefore, it is important to monitor kidney function regularly while a client is on Metformin. Hemoglobin A1C is used to monitor long-term glucose control, but kidney function is the priority for monitoring Metformin therapy.

3. A client has a new prescription for Metoclopramide to treat nausea. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication before bedtime.
• B. I will discontinue this medication if I experience drowsiness.
• C. I should report restlessness or involuntary movements.
• D. This medication can change the color of my urine to orange.

Correct answer: C

Rationale: The correct answer is C. Reporting restlessness or involuntary movements is crucial as they can be signs of extrapyramidal symptoms, a potential side effect of Metoclopramide. These symptoms should be reported promptly to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because taking the medication before bedtime, discontinuing it due to drowsiness, or expecting urine color changes are not relevant teaching points for Metoclopramide use.

4. A healthcare professional is preparing to administer vancomycin to a client. The professional should monitor for which of the following adverse effects?

• A. Nephrotoxicity
• B. Hepatotoxicity
• C. Red Man Syndrome
• D. Diarrhea

Correct answer: C

Rationale: Red Man Syndrome is a common adverse effect of vancomycin characterized by flushing and rash. It is not related to nephrotoxicity, hepatotoxicity, or diarrhea. Monitoring for this reaction allows for prompt intervention to prevent severe complications.

5. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.

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