Nursing Elites

1. A healthcare professional prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the professional reviews the action of the medication and understands that it:

• A. Releases bicarbonate in exchange for primarily sodium ions
• B. Releases sodium ions in exchange for primarily potassium ions
• C. Releases potassium ions in exchange for primarily sodium ions
• D. Releases sodium ions in exchange for primarily bicarbonate ions

Correct answer: B

Rationale: Sodium polystyrene sulfonate, such as Kayexalate, is a cation exchange resin that functions by releasing sodium ions in exchange for primarily potassium ions. This medication is commonly used to treat hyperkalemia, a condition characterized by elevated levels of potassium in the blood.

2. A client is receiving bethanechol chloride (Urecholine). The nurse monitors the client for adverse effects of the medication and should observe for which of the following?

• A. Bradycardia
• B. Constipation
• C. Hypertension
• D. Dry mouth

Correct answer: A

Rationale: Corrected Rationale: Bethanechol chloride (Urecholine) stimulates muscarinic receptors, which can lead to bradycardia as an adverse effect. Monitoring for bradycardia is crucial when administering this medication. Constipation, hypertension, and dry mouth are not typically associated with the effects of bethanechol chloride. Bradycardia is the correct adverse effect to monitor for, making option A the correct answer. Constipation, hypertension, and dry mouth are not commonly seen with bethanechol chloride and are therefore incorrect choices.

3. A client is taking levothyroxine (Synthroid) for hypothyroidism. Which symptom would indicate to the nurse that the client is taking too much medication?

• A. Bradycardia
• B. Lethargy
• C. Tremors
• D. Constipation

Correct answer: C

Rationale: When a client is taking an excessive dose of levothyroxine (Synthroid), it can lead to symptoms of hyperthyroidism. Tremors are a common sign of excessive medication, along with tachycardia and insomnia. Bradycardia, lethargy, and constipation are typical symptoms of hypothyroidism, indicating that the client may require a higher dose of levothyroxine rather than too much.

4. Why is prostaglandin E1 prescribed for a child with transposition of the great arteries?

• A. Prevents hypercyanotic (blue or tet) spells
• B. Maintains an adequate hormone level
• C. Maintains the position of the great arteries
• D. Provides adequate oxygen saturation and maintains cardiac output

Correct answer: D

Rationale: Prostaglandin E1 is prescribed for a child with transposition of the great arteries to increase blood mixing, which helps maintain adequate oxygen saturation and cardiac output. This medication does not prevent hypercyanotic spells, maintain hormone levels, or influence the position of the great arteries.

5. A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:

• A. Both are weak potassium-losing diuretics.
• B. The combination of these medications prevents renal toxicity.
• C. Hydrochlorothiazide is less expensive, so using a combination of diuretics is cost-effective.
• D. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.

Correct answer: D

Rationale: The combination of triamterene and hydrochlorothiazide is used because triamterene is a potassium-sparing diuretic, which helps retain potassium, while hydrochlorothiazide is a potassium-losing diuretic, which promotes potassium excretion. This combination helps balance potassium levels in the body, preventing imbalances that can occur when using potassium-losing diuretics alone.

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