Nursing Elites

1. The client with a diagnosis of heart failure is prescribed spironolactone (Aldactone). Which laboratory value should be monitored closely by the nurse?

• A. Serum calcium
• B. Serum potassium
• C. Serum sodium
• D. Serum glucose

Correct answer: B

Rationale: The correct answer is B: Serum potassium. Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia. Monitoring serum potassium levels is crucial to prevent adverse effects associated with high potassium levels, such as cardiac arrhythmias. Monitoring serum calcium (choice A) is not directly related to spironolactone use. Serum sodium (choice C) and serum glucose (choice D) are also not the primary laboratory values to monitor when a client is prescribed spironolactone for heart failure.

2. A client is taking furosemide. Which of the following findings should the nurse report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Increased appetite

Correct answer: C

Rationale: Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. Hypokalemia is a serious electrolyte imbalance that can cause various cardiac and muscular issues. Therefore, the nurse should promptly report hypokalemia to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because weight gain, dry cough, and increased appetite are not typically associated with furosemide use and are not immediate concerns that require urgent reporting.

3. A client is admitted with an arterial ischemic leg ulcer. The nurse expects to note that this ulcer has which typical characteristic?

• A. Dark pink base
• B. Deep and painful
• C. Accompanied by very slight pain
• D. Brown pigmentation of surrounding skin

Correct answer: B

Rationale: Arterial ischemic ulcers are typically characterized by being deep and painful, often with a pale or necrotic base. The lack of adequate blood flow leads to tissue damage, resulting in these ulcers having a deep appearance and causing significant pain to the individual. The other options are not commonly associated with arterial ischemic ulcers; a dark pink base, very slight pain, or brown pigmentation of surrounding skin are not typical features of this type of ulcer.

4. What preoperative instruction should the LPN/LVN reinforce to a client scheduled for a carotid endarterectomy?

• A. You will need to be NPO after midnight before the surgery.
• B. You should avoid deep breathing and coughing after the surgery.
• C. You will be able to eat and drink normally after the procedure.
• D. You can take all of your prescribed medications the morning of surgery.

Correct answer: A

Rationale: The correct preoperative instruction that the LPN/LVN should reinforce to a client scheduled for a carotid endarterectomy is being NPO after midnight before the surgery. This instruction is essential to prevent aspiration and ensure a safe procedure. Avoiding oral intake helps reduce the risk of complications during anesthesia induction and the surgical process. Choices B, C, and D are incorrect because avoiding deep breathing and coughing, resuming normal eating and drinking, and taking all prescribed medications the morning of surgery are not recommended preoperative instructions for a carotid endarterectomy.

5. A client with a history of coronary artery disease is prescribed atorvastatin (Lipitor). What side effect should the nurse instruct the client to immediately report?

• A. Muscle pain or tenderness
• B. Constipation
• C. Dry mouth
• D. Drowsiness

Correct answer: A

Rationale: The correct answer is 'Muscle pain or tenderness.' This can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin (Lipitor). Rhabdomyolysis is a condition in which muscle breakdown releases a protein that can damage the kidneys. Therefore, it is crucial for the client to report any muscle pain or tenderness immediately to prevent further complications. Choices B, C, and D are incorrect because they are not typically associated with atorvastatin (Lipitor) use or indicative of a serious adverse effect that requires immediate reporting.

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