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 healthcare professional is preparing to administer a transfusion of 300 mL of pooled platelets for a client with severe Thrombocytopenia. How should the healthcare professional plan to administer the transfusion over which of the following time frames?

• A. Within 30 minutes/unit
• B. Within 60 minutes/unit
• C. Within 2 hours/unit
• D. Within 4 hours/unit

Correct answer: A

Rationale: Platelets are fragile components that must be administered promptly to minimize the risk of clumping. The correct administration time for platelets is within 15 to 30 minutes per unit to maintain their therapeutic effectiveness and reduce adverse effects. Administering platelets over longer time frames can lead to decreased efficacy and potential harm to the patient. Therefore, the correct answer is to administer the 300 mL of pooled platelets within 30 minutes per unit.

3. A client is being discharged and will start long-term oral prednisone for chronic asthma treatment. The client should monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is an adverse effect of oral prednisone due to sodium and water retention, which leads to fluid retention. This can be monitored by tracking weight changes. Nervousness (Choice B) is not a common adverse effect of prednisone. Bradycardia (Choice C) is not typically associated with prednisone use; in fact, tachycardia can be more common. Constipation (Choice D) is not a prominent adverse effect of prednisone.

4. A client with osteoporosis has a new prescription for alendronate. Which of the following instructions should the nurse provide?

• A. Take the medication with a meal.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Take the medication with a glass of juice.
• D. Take the medication with milk or food.

Correct answer: B

Rationale: The correct instruction for a client taking alendronate is to remain upright for at least 30 minutes after administration. This is essential to prevent esophageal irritation and ensure the medication reaches the stomach properly. Remaining upright reduces the risk of side effects such as esophagitis. Choices A, C, and D are incorrect as alendronate should not be taken with a meal, juice, milk, or food to optimize its absorption and effectiveness.

5. A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.

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