Nursing Elites

1. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.

2. When starting Alfuzosin for the treatment of Benign Prostatic Hyperplasia, a nurse is providing teaching to a client. The nurse should instruct the client that which of the following is an adverse effect of this medication?

• A. Bradycardia
• B. Edema
• C. Hypotension
• D. Tremor

Correct answer: C

Rationale: The correct adverse effect of Alfuzosin is hypotension. Alfuzosin relaxes muscle tone in veins, leading to decreased cardiac output and subsequent hypotension. Patients on this medication should be advised to change positions slowly to prevent a sudden drop in blood pressure. Choice A, Bradycardia, is not a common adverse effect of Alfuzosin. Choice B, Edema, is not typically associated with Alfuzosin use. Choice D, Tremor, is also not a common adverse effect of Alfuzosin.

3. A client in an outpatient facility is taking Acarbose for type 2 Diabetes Mellitus. Which of the following laboratory tests should the nurse plan to monitor?

• A. WBC
• B. Serum potassium
• C. Platelet count
• D. Liver function test

Correct answer: D

Rationale: The correct answer is D: Liver function test. Acarbose, used for type 2 Diabetes Mellitus, can lead to liver toxicity with long-term use. Monitoring liver function tests periodically is crucial to detect any signs of liver dysfunction early and prevent complications. Choices A, B, and C are incorrect as Acarbose does not directly affect WBC, serum potassium, or platelet count levels.

4. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.

5. A client with heart failure is prescribed digoxin. Which statement by the client indicates an adverse effect of the medication?

• A. I can walk a mile a day.
• B. I've had a backache for several days.
• C. I am urinating more frequently.
• D. I feel nauseated and have no appetite.

Correct answer: D

Rationale: Nausea and loss of appetite are common early signs of digoxin toxicity, indicating an adverse effect of the medication. These symptoms should be reported to the healthcare provider immediately for further evaluation and management.

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