Nursing Elites

1. The client with diabetes mellitus should be cautioned by the nurse taking a sulfonylurea that alcoholic beverages should be avoided while taking these drugs because they can cause which of the following?

• A. Hypokalemia.
• B. Hyperkalemia.
• C. Hypocalcemia.
• D. Disulfiram (Antabuse)-like symptoms.

Correct answer: D

Rationale: The correct answer is D: Disulfiram (Antabuse)-like symptoms. When a client with diabetes mellitus taking a sulfonylurea consumes alcohol, it can lead to disulfiram-like symptoms, such as nausea, flushing, and palpitations. Choice A, hypokalemia, is incorrect because sulfonylureas do not typically lead to low potassium levels. Choice B, hyperkalemia, is incorrect as sulfonylureas are not associated with high potassium levels. Choice C, hypocalcemia, is also incorrect because sulfonylureas are not known to cause low calcium levels.

2. The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this diagnosis?

• A. Frequent use of chewable and liquid antacids for indigestion
• B. Severe abdominal cramps and diarrhea after eating spicy foods
• C. Upper mid-abdominal gnawing and burning pain
• D. Marked weight loss and appetite over the last 3 to 4 months

Correct answer: C

Rationale: The correct answer is C: 'Upper mid-abdominal gnawing and burning pain.' This symptom is a classic presentation of peptic ulcer disease. Antacids (choice A) may provide relief but do not confirm the diagnosis. Severe abdominal cramps and diarrhea (choice B) are more suggestive of other conditions like irritable bowel syndrome. Weight loss and appetite changes (choice D) are non-specific and could be related to various health issues.

3. What information will the nurse provide when counseling a patient starting a sulfonamide drug for a urinary tract infection?

• A. Drink several quarts of water daily.
• B. If stomach upset occurs, avoid taking antacids.
• C. Limit sun exposure to avoid skin reactions.
• D. Report any sore throat promptly.

Correct answer: A

Rationale: The correct answer is A: Drink several quarts of water daily. This advice aims to prevent crystalluria, a potential side effect of sulfonamide drugs. Option B is incorrect because antacids should not be taken with sulfonamides as they can decrease drug absorption. Option C is incorrect as sulfonamides can increase sensitivity to sunlight, not requiring sun exposure limitations but sun protection measures. Option D is incorrect because a sore throat could indicate a more serious adverse effect and should be promptly reported for evaluation.

4. The client with chronic renal failure is being taught about dietary restrictions by the nurse. Which of the following food items should the client avoid?

• A. Apples
• B. Bananas
• C. Chicken
• D. Rice

Correct answer: B

Rationale: The correct answer is B: Bananas. Bananas are high in potassium, which should be limited in clients with chronic renal failure to prevent hyperkalemia. Apples (choice A), chicken (choice C), and rice (choice D) are not typically restricted in clients with chronic renal failure. Apples and rice are lower in potassium, while chicken is a good source of lean protein, which is usually encouraged in these clients to meet their protein needs without excess potassium intake.

5. A client admitted with left-sided heart failure has a heart rate of 110 beats per minute and is becoming increasingly dyspneic. Which additional assessment finding by the nurse supports the client's admitting diagnosis?

• A. An enlarged, distended abdomen.
• B. Crackles in the bases of both lungs.
• C. Jugular vein distension.
• D. Peripheral edema.

Correct answer: B

Rationale: The correct answer is B. Crackles in the bases of the lungs are indicative of fluid accumulation, which is common in left-sided heart failure. In left-sided heart failure, the heart is unable to effectively pump blood from the lungs to the rest of the body, leading to a backup of fluid in the lungs. This results in crackles heard on auscultation. Choices A, C, and D are not specific to left-sided heart failure. An enlarged, distended abdomen may indicate ascites or liver congestion. Jugular vein distension is more commonly associated with right-sided heart failure, and peripheral edema is a sign of fluid accumulation in the tissues, which can occur in both types of heart failure but is not as specific to left-sided heart failure as crackles in the lungs.

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