Nursing Elites

1. Why is it important to monitor ins and outs in patients using ACE inhibitors?

• A. To assess for renal impairment
• B. To ensure the patient is receiving adequate fluid intake
• C. To assess the patient for potential heart failure
• D. To assess for NSAID use

Correct answer: A

Rationale: It is crucial to monitor ins and outs in patients using ACE inhibitors to assess for renal impairment. ACE inhibitors can affect renal function, potentially leading to renal impairment. Monitoring the patient's fluid balance helps in early recognition of any renal issues and allows for timely interventions to prevent complications.

2. A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, what advice should the nurse provide?

• A. Avoid using acetaminophen for headaches.
• B. Restrict intake of foods high in sodium.
• C. Decrease fluid intake to less than 1,500 mL daily.
• D. Limit aerobic activity in hot weather.

Correct answer: D

Rationale: The nurse should advise the client to limit aerobic activity in hot weather to prevent sodium/water depletion, which can increase the risk for Lithium toxicity. Excessive sweating and fluid loss can lead to dehydration and changes in lithium levels, potentially resulting in toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting sodium intake and decreasing fluid intake can lead to increased lithium levels and toxicity, so these are not recommended actions.

3. A client is prescribed Digoxin. Which of the following findings should the nurse monitor as a sign of potential toxicity?

• A. Bradycardia
• B. Hypertension
• C. Hyperglycemia
• D. Hypocalcemia

Correct answer: A

Rationale: Bradycardia is a common sign of Digoxin toxicity. Digoxin can lead to toxicity, which can manifest as various signs and symptoms, including bradycardia. Monitoring the client's heart rate closely is crucial to detect and manage potential toxicity early. Hypertension, hyperglycemia, and hypocalcemia are not typically associated with Digoxin toxicity; therefore, they are incorrect choices.

4. A client has a new prescription for spironolactone. The nurse should instruct the client to avoid which of the following foods?

• A. Salt substitutes
• B. Apples
• C. Chicken
• D. Bananas

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic. The client should avoid salt substitutes because they often contain potassium, which could lead to hyperkalemia. Hyperkalemia, or high levels of potassium in the blood, is a potential side effect of spironolactone, and ingesting additional potassium from salt substitutes can exacerbate this risk.

5. A client has a new prescription for Metoprolol. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Avoid sudden discontinuation of the medication.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is to instruct the client to avoid sudden discontinuation of Metoprolol. Metoprolol is a beta-blocker that should be tapered off gradually to prevent rebound hypertension and other cardiac issues. Abruptly stopping Metoprolol can lead to serious complications, so it is essential for the client to follow the healthcare provider's guidance on discontinuation. Choice A is incorrect because Metoprolol can be taken with or without food. Choice B is incorrect as Metoprolol is not typically associated with causing hyperglycemia. Choice D is also incorrect as there is no need to increase potassium-rich foods specifically due to taking Metoprolol.

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