Nursing Elites

1. Which of the following is a potassium-sparing diuretic?

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

Correct answer: B

Rationale: Spironolactone is classified as a potassium-sparing diuretic. It works by antagonizing the aldosterone receptor, leading to potassium retention and sodium excretion. This mechanism makes it a suitable choice for conditions where potassium retention is desired, such as in patients with heart failure or liver cirrhosis. Choices A, C, and D are not potassium-sparing diuretics. Furosemide, hydrochlorothiazide, and bumetanide are loop diuretics and thiazide diuretics, respectively, which promote the excretion of potassium.

2. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: Fever is a key symptom of serotonin syndrome, a potentially serious condition that can occur with the use of SSRIs like Sertraline. Serotonin syndrome is characterized by excessive levels of serotonin in the body, leading to symptoms such as fever, agitation, confusion, tremors, and sweating. If a client on Sertraline presents with fever, the nurse should consider the possibility of serotonin syndrome and take appropriate actions such as notifying the healthcare provider and monitoring the client closely. Bruising, abdominal pain, and rash are not typically associated with serotonin syndrome and are more likely to be indicative of other conditions or side effects.

3. A client has a new prescription for Sucralfate to treat a duodenal ulcer. Which of the following instructions should be included?

• A. Take the medication with meals.
• B. Swallow the tablet whole.
• C. Take the medication 1 hour before meals.
• D. Chew the tablet before swallowing.

Correct answer: C

Rationale: The correct instruction for taking Sucralfate is to take it 1 hour before meals. This timing allows the medication to coat the stomach lining, providing a protective barrier against stomach acid, which aids in healing the duodenal ulcer. Option A is incorrect as it contradicts the correct timing for taking Sucralfate. Option B is not necessary as it does not pertain to how the medication should be taken in relation to meals. Option D is incorrect as chewing the tablet before swallowing is not the correct administration method for Sucralfate.

4. A client is being educated by a healthcare provider about managing Digoxin toxicity. Which statement by the client demonstrates an understanding of the teaching?

• A. I will take an extra dose of Digoxin if I miss one.
• B. I should notify my healthcare provider if I experience visual changes.
• C. I will stop taking Digoxin if my heart rate is below 70 bpm.
• D. I should take antacids to alleviate gastrointestinal upset.

Correct answer: B

Rationale: The correct answer is B. Visual changes, such as yellow or blurred vision, can be indicative of digoxin toxicity. It is crucial for clients to inform their healthcare provider promptly if they encounter these symptoms. Prompt medical attention can help manage potential toxicity and prevent complications. Choices A, C, and D are incorrect because taking an extra dose of Digoxin, stopping Digoxin based on heart rate alone, and using antacids for gastrointestinal upset are not appropriate actions when managing Digoxin toxicity.

5. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

• A. This medication can safely be taken during pregnancy.
• B. Eliminate grapefruit juice from your diet.
• C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
• D. Notify your provider if you develop a rash.

Correct answer: B

Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.

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