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 client has been prescribed an ACE Inhibitor for hypertension. Which of the following instructions should be included by the healthcare provider?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Avoid foods high in potassium.
• D. Limit your fluid intake.

Correct answer: A

Rationale: The correct answer is to 'Avoid salt substitutes.' ACE Inhibitors can increase potassium levels, so clients should avoid salt substitutes that contain potassium to prevent hyperkalemia, which is a potential side effect of ACE Inhibitors. Choice B 'Take this medication at bedtime' is incorrect as ACE Inhibitors are usually taken in the morning to avoid nocturnal diuresis. Choice C 'Avoid foods high in potassium' is incorrect because although ACE Inhibitors can increase potassium levels, clients are generally encouraged to consume potassium-rich foods in moderation unless contraindicated. Choice D 'Limit your fluid intake' is also incorrect as ACE Inhibitors do not typically require fluid restrictions unless specified by a healthcare provider for other reasons.

3. A healthcare professional is preparing to administer Diltiazem IV to a client who has atrial fibrillation. Which of the following findings should the healthcare professional report immediately?

• A. Bradycardia.
• B. Hypertension.
• C. Shortness of breath.
• D. Tachycardia.

Correct answer: A

Rationale: The correct answer is bradycardia. Diltiazem, a calcium channel blocker, can lead to bradycardia as a side effect. Bradycardia should be reported immediately because it can result in serious cardiac complications, especially in a client with atrial fibrillation. Hypertension, shortness of breath, and tachycardia are not typically associated with Diltiazem administration and would not be immediate concerns in this scenario.

4. When completing a nursing history for a client taking Simvastatin, which of the following disorders should the nurse identify as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in clients with active moderate-to-severe liver disorders, particularly if they are already on a statin like simvastatin. Hepatitis C is a liver condition that can be exacerbated by Ezetimibe, leading to potential complications. Therefore, the nurse should identify active hepatitis C as a contraindication to adding Ezetimibe to the client's medications. Choices A, B, and D are incorrect because they are not directly related to the contraindication of Ezetimibe in clients taking Simvastatin.

5. A healthcare professional is caring for a client who has a new prescription for Lisinopril. Which of the following laboratory values should the professional monitor?

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

Correct answer: A

Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing the excretion of potassium in the kidneys. Monitoring serum potassium levels is essential to prevent complications such as cardiac arrhythmias. Therefore, the healthcare professional should closely monitor the client's serum potassium levels when they are on Lisinopril. Choices B, C, and D are incorrect because Lisinopril primarily affects potassium levels due to its mechanism of action as an ACE inhibitor. Serum sodium, calcium, and magnesium levels are not typically affected by Lisinopril in the same way as potassium.

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