Nursing Elites

1. What side effect should be monitored for in a patient with chronic heart failure taking spironolactone?

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

Correct answer: B

Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. One of the potential side effects of spironolactone therapy is hyperkalemia, which is an elevated level of potassium in the blood. Hyperkalemia can lead to serious cardiac arrhythmias, making it crucial for healthcare providers to monitor potassium levels closely. Choices A, C, and D are incorrect because hypokalemia (low potassium levels), hyponatremia (low sodium levels), and hypernatremia (high sodium levels) are not typically associated with spironolactone use in patients with chronic heart failure.

2. A client who has just started taking levodopa-carbidopa (Sinemet) for Parkinson's disease reports experiencing nausea. What should the nurse recommend to the client?

• A. Take the medication on an empty stomach.
• B. Consume a low-protein snack with the medication.
• C. Increase your intake of dairy products.
• D. Stop taking the medication and notify your healthcare provider.

Correct answer: B

Rationale: Nausea is a common side effect of levodopa-carbidopa (Sinemet). Consuming a low-protein snack with the medication can help reduce nausea. The protein in food can compete with levodopa for absorption, so taking it with a low-protein snack may improve its effectiveness and reduce gastrointestinal side effects. Option A is incorrect as taking the medication on an empty stomach may exacerbate nausea. Option C is incorrect because increasing intake of dairy products is not recommended to alleviate nausea. Option D is incorrect because abruptly stopping the medication without healthcare provider guidance can lead to adverse effects.

3. A client's telemetry monitor indicates the sudden onset of ventricular fibrillation. Which assessment finding should the nurse anticipate?

• A. Bounding erratic pulse.
• B. Regularly irregular pulse.
• C. Thready irregular pulse.
• D. No palpable pulse.

Correct answer: D

Rationale: Ventricular fibrillation is a life-threatening arrhythmia characterized by chaotic, asynchronous contractions of the ventricles, resulting in ineffective cardiac output. This leads to the absence of a palpable pulse. Nurses should be prepared to initiate immediate interventions such as defibrillation to restore normal cardiac rhythm in a client experiencing ventricular fibrillation.

4. What skin care instructions should the nurse give to a patient receiving external beam radiation therapy for cancer treatment?

• A. Use a heating pad to relieve any pain in the treated area.
• B. Apply alcohol-based lotions to the treated area daily.
• C. Avoid exposing the treated area to sunlight.
• D. Wash the treated area with hot water and strong soap.

Correct answer: C

Rationale: Patients undergoing external beam radiation therapy should be advised to avoid exposing the treated area to sunlight to prevent further skin damage. Heat sources like heating pads should be avoided to prevent burns and irritation to the skin. Alcohol-based lotions can be irritating to the skin and are not recommended. Washing the treated area with lukewarm water and mild soap is preferable to maintain skin integrity and prevent irritation. Therefore, the correct instruction for the patient is to avoid exposing the treated area to sunlight.

5. A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?

• A. Administer a Fleet enema as prescribed and remain with the client
• B. Contact the primary care provider promptly and report these signs of perforation
• C. Position the client supine and insert an NG tube
• D. Page the primary provider and report that the client may be obstructed

Correct answer: B

Rationale: In a client with acute diverticulitis experiencing sudden increase in temperature, exquisite abdominal tenderness, and uncharacteristic abdominal rigidity, these signs suggest a possible perforation. The nurse should promptly contact the primary care provider to report these signs, as perforation requires immediate medical attention to prevent further complications.

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