Nursing Elites

1. What is the most common side effect of diuretics such as furosemide (Lasix)?

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

Correct answer: A

Rationale: The correct answer is 'Hypokalemia.' Diuretics like furosemide increase the excretion of potassium, leading to hypokalemia as a common side effect. Hyperkalemia (choice B) is the opposite condition characterized by high potassium levels, which is not typically associated with furosemide use. Hypernatremia (choice C) is increased sodium levels, while hyponatremia (choice D) is decreased sodium levels, neither of which are the most common side effects of furosemide. Therefore, choice A is the best answer.

2. The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic encephalopathy. Which finding would the nurse consider an indication of progressive hepatic encephalopathy?

• A. An increase in abdominal girth.
• B. Hypertension and a bounding pulse.
• C. Decreased bowel sounds.
• D. Difficulty in handwriting.

Correct answer: D

Rationale: Difficulty in handwriting is a common early sign of hepatic encephalopathy. Changes in handwriting can indicate progression or reversal of hepatic encephalopathy leading to coma. Choice (A) is a sign of ascites, not hepatic encephalopathy. Hypertension and a bounding pulse (Choice B) are not typically associated with hepatic encephalopathy. Decreased bowel sounds (Choice C) do not directly indicate an increase in serum ammonia level, which is the primary cause of hepatic encephalopathy.

3. The nurse is preparing to administer the first dose of intravenous ceftriaxone (Rocephin) to a patient. When reviewing the patient’s chart, the nurse notes that the patient previously experienced a rash when taking amoxicillin. What is the nurse’s next action?

• A. Administer the drug and observe closely for hypersensitivity reactions.
• B. Ask the provider whether a cephalosporin from a different generation may be used.
• C. Contact the provider to report drug hypersensitivity.
• D. Notify the provider and suggest an oral cephalosporin.

Correct answer: A

Rationale: When a patient has a history of a rash with amoxicillin, a beta-lactam antibiotic like ceftriaxone should be administered cautiously due to a possible cross-reactivity. The nurse should still administer the drug but closely monitor the patient for any signs of hypersensitivity reactions. Asking for a different generation of cephalosporin or suggesting an oral form does not address the potential cross-reactivity issue. Contacting the provider to report drug hypersensitivity would delay care when the patient needs immediate treatment.

4. The client with chronic renal failure is receiving hemodialysis. Which of the following laboratory values should the nurse monitor closely?

• A. Hemoglobin level.
• B. Blood urea nitrogen (BUN) level.
• C. Serum potassium level.
• D. Creatinine level.

Correct answer: C

Rationale: The serum potassium level should be monitored closely in clients undergoing hemodialysis due to the risk of hyperkalemia. Hemodialysis is used to remove waste products and excess electrolytes like potassium from the blood. Monitoring potassium levels is crucial because an imbalance can lead to serious cardiac complications, making it the priority value to monitor in this scenario. Monitoring hemoglobin levels (choice A) is important for anemia assessment in chronic renal failure but is not directly related to hemodialysis. Blood urea nitrogen (BUN) levels (choice B) and creatinine levels (choice D) are commonly monitored in renal function tests but are not the top priority for monitoring in a client undergoing hemodialysis.

5. The client is planning care for a client who is receiving hemodialysis. Which of the following interventions should be included in the plan of care?

• A. Administer anticoagulants to prevent clot formation.
• B. Monitor the client for signs of infection.
• C. Provide the client with a high-protein diet.
• D. Encourage the client to drink at least 2 liters of fluid daily.

Correct answer: B

Rationale: Monitoring for signs of infection is crucial in clients receiving hemodialysis because they are at an increased risk of infection due to the invasive nature of the procedure. Administering anticoagulants is not typically a part of the routine care for clients undergoing hemodialysis unless specifically prescribed. While a high-protein diet may be beneficial for some clients, it is not a specific intervention related to hemodialysis. Encouraging fluid intake must be individualized based on the client's fluid status and should not be a generalized recommendation for all clients receiving hemodialysis.

Similar Questions