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. Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?

• A. 45 minutes to 18 hours
• B. 30 minutes to 12 hours
• C. 90 minutes to 36 hours
• D. 60 minutes to 24 hours

Correct answer: B

Rationale: Reteplase (Retavase) is a thrombolytic medication used in the treatment of myocardial infarction (MI). It is crucial to administer this drug within 30 minutes to 12 hours following the onset of symptoms to achieve optimal therapeutic effects and improve patient outcomes. Administering Reteplase within this time frame helps in restoring blood flow to the affected areas of the heart by dissolving blood clots, reducing myocardial damage, and potentially preventing further complications associated with MI.

3. When teaching a client with a new prescription for Clopidogrel, which laboratory value should the nurse monitor to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication that works by reducing the formation of blood clots. Therefore, the nurse should monitor the client's platelet count to assess for potential bleeding complications. A decrease in platelet count could indicate a risk of bleeding, which is an adverse effect associated with Clopidogrel therapy. Monitoring other laboratory values like white blood cell count, hemoglobin, and blood glucose is important for assessing overall health status but is not directly related to the potential adverse effects of Clopidogrel.

4. A client is starting a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Weigh yourself daily.
• C. Take potassium supplements as needed.
• D. Decrease intake of foods high in sodium.

Correct answer: B

Rationale: When a client is prescribed furosemide, it is important to monitor for fluid loss. Weighing oneself daily helps track changes in weight due to fluid loss, which can indicate the effectiveness of the medication. This monitoring assists in managing fluid balance and adjusting the dosage if necessary to achieve the desired therapeutic effect. Choice A is incorrect because furosemide is usually recommended to be taken on an empty stomach. Choice C is incorrect because potassium supplements should only be taken if prescribed by a healthcare provider due to the risk of hyperkalemia with furosemide. Choice D is incorrect because decreasing sodium intake is generally a good dietary practice but not a specific instruction related to furosemide therapy.

5. When teaching a client who has a new prescription for Ciprofloxacin, which of the following instructions should the nurse include?

• A. Take this medication with an antacid.
• B. Avoid direct sunlight.
• C. Increase your intake of dairy products.
• D. Expect urine to turn orange.

Correct answer: B

Rationale: The correct instruction for a client prescribed Ciprofloxacin is to avoid direct sunlight. Ciprofloxacin can cause photosensitivity, increasing the risk of sunburn. Clients should be advised to avoid direct sunlight and wear protective clothing, including hats and sunglasses when going outdoors to prevent skin damage. Choices A, C, and D are incorrect. Taking Ciprofloxacin with an antacid can reduce its absorption, so they should not be taken together. Increasing dairy product intake is not necessary or relevant to taking Ciprofloxacin. While Ciprofloxacin can discolor urine, turning it orange, this is not a critical side effect that requires specific instructions for the client.

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