Nursing Elites

1. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?

• A. Spironolactone
• B. Furosemide
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: A

Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.

2. A healthcare provider is caring for a client who is prescribed Furosemide. Which of the following laboratory values should the healthcare provider monitor?

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

Correct answer: A

Rationale: Corrected Rationale: Furosemide is a loop diuretic that can lead to hypokalemia (low potassium levels) due to increased potassium excretion. Monitoring serum potassium levels is crucial to prevent complications such as cardiac dysrhythmias associated with hypokalemia. Choice B, serum calcium, is incorrect because Furosemide does not directly impact calcium levels. Choice C, serum sodium, is less commonly affected by Furosemide use. Choice D, serum magnesium, is not the primary electrolyte affected by Furosemide, although magnesium levels may be affected indirectly.

3. A nurse is providing instructions to a client who has a prescription for Amoxicillin and Clarithromycin to treat a Peptic Ulcer. Which of the following information should the nurse include in the teaching?

• A. Take these medications with foo '
• B. These medications can turn your stool black.'
• C. These medications can cause photosensitivity.'
• D. The purpose of these medications is to decrease the pH of gastric juices in the stomach.'

Correct answer: A

Rationale: The nurse should instruct the client to take these medications with food to reduce GI disturbances.

4. A healthcare professional is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare professional plan to take?

• A. Administer IM Enoxaparin along with the Alteplase dose.
• B. Hold direct pressure on puncture sites for up to 30 min.
• C. Administer Aminocaproic acid IV prior to alteplase infusion.
• D. Prepare to administer Alteplase within 8 hr of manifestation onset.

Correct answer: B

Rationale: The correct intervention when administering IV Alteplase is to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This helps prevent bleeding complications associated with thrombolytic therapy. Administering IM Enoxaparin is not indicated with Alteplase, as it is an anticoagulant rather than a thrombolytic agent. Aminocaproic acid is not typically administered prior to alteplase infusion in the context of a massive Pulmonary Embolism. While timely administration of Alteplase is important, the specific timeframe within which it should be administered may vary based on the clinical situation, so a strict 8-hour window is not universally applicable.

5. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?

• A. Uroprotectant agent, such as mesna
• B. Opioid, such as morphine
• C. Loop diuretic, such as furosemide
• D. H1 receptor antagonist, such as diphenhydramine

Correct answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

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