Nursing Elites

1. When starting therapy with Lisinopril, a client should be instructed to monitor for which of the following adverse effects?

• A. Tinnitus
• B. Diarrhea
• C. Cough
• D. Weight gain

Correct answer: C

Rationale: The correct answer is C: Cough. Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. Clients should be informed to monitor for this side effect and report it to their healthcare provider if it occurs. Choices A, B, and D are incorrect because tinnitus, diarrhea, and weight gain are not commonly associated with Lisinopril therapy.

2. How do ACE inhibitors work?

• A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
• B. Block stimulation of beta 1 and beta 2 at the receptor sites
• C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
• D. None of the above

Correct answer: C

Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.

3. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following foods should the provider instruct the client to avoid?

• A. Broccoli
• B. Bananas
• C. Chicken
• D. Potatoes

Correct answer: A

Rationale: Clients taking Warfarin should avoid foods high in vitamin K, such as broccoli, as they can interfere with the effectiveness of the medication. Vitamin K can counteract the anticoagulant effects of Warfarin, potentially leading to blood clotting issues. Broccoli is rich in vitamin K, so its consumption should be consistent to avoid fluctuations in the medication's effectiveness. Bananas, chicken, and potatoes are not known to significantly interact with Warfarin and do not pose a risk of affecting its anticoagulant properties.

4. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

5. A nurse is providing discharge teaching to a client who has a new prescription for Warfarin. Which of the following statements should the nurse include?

• A. You should avoid taking aspirin for headaches while on this medication.
• B. You should use a soft toothbrush to brush your teeth.
• C. You should avoid foods that are rich in vitamin K.
• D. You should avoid prolonged exposure to sunlight.

Correct answer: B

Rationale: The correct statement to include in discharge teaching for a client prescribed Warfarin is to use a soft toothbrush to prevent gum bleeding. Warfarin is an anticoagulant that increases the risk of bleeding, so using a soft toothbrush can help prevent gum injury and bleeding. Choice A is incorrect because aspirin, another blood-thinning medication, should generally be avoided while on Warfarin to reduce the risk of bleeding. Choice C is incorrect because clients on Warfarin should maintain a consistent intake of vitamin K-rich foods rather than avoid them completely. Choice D is unrelated to the medication and not a priority teaching point for a client prescribed Warfarin.

Similar Questions