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. A client has a new prescription for Amlodipine. Which of the following side effects should the client monitor for and report?

• A. Swelling of the ankles.
• B. Increased urination.
• C. Persistent cough.
• D. Dark-colored urine.

Correct answer: A

Rationale: Corrected Rationale: Amlodipine, a calcium channel blocker, can cause peripheral edema (swelling of the ankles) as a side effect. This occurs due to the dilation of blood vessels and increased fluid retention. It is important for the client to monitor for ankle swelling as it could indicate a potential adverse reaction to the medication. Reporting this side effect to the healthcare provider is crucial to ensure appropriate management and potential adjustment of the treatment plan.\n Choice B, increased urination, is not a common side effect of Amlodipine. Choice C, persistent cough, is more commonly associated with ACE inhibitors rather than calcium channel blockers like Amlodipine. Choice D, dark-colored urine, is not a typical side effect of Amlodipine and is not something the client should specifically monitor for and report while taking this medication.

3. When educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of green, leafy vegetables.
• D. Expect your stools to turn clay-colored.

Correct answer: B

Rationale: The correct instruction for the nurse to include when educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia is to avoid drinking grapefruit juice. Grapefruit juice can increase the blood levels of atorvastatin, leading to an elevated risk of serious side effects such as liver damage and muscle problems. It is essential for the client to be aware of this potential interaction and to follow the nurse's advice to avoid grapefruit juice while taking Atorvastatin. Choices A, C, and D are incorrect. Taking Atorvastatin in the morning is a common recommendation but not the priority over avoiding grapefruit juice. Increasing intake of green, leafy vegetables is generally a healthy dietary choice but is not specific to the medication. Expecting stools to turn clay-colored is not a common side effect of Atorvastatin.

4. A client has a new prescription for Beclomethasone. Which of the following instructions should the nurse include in the teaching?

• A. Take the medication with meals.
• B. Increase your intake of calcium-rich foods.
• C. Rinse your mouth after each use.
• D. Limit fluid intake while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'Rinse your mouth after each use.' Beclomethasone can cause oral candidiasis (thrush) as an adverse effect. Rinsing the mouth after each use helps reduce the risk of developing thrush by removing any residue of the medication from the mouth, which can promote fungal growth. Choices A, B, and D are incorrect. Taking the medication with meals, increasing calcium-rich foods intake, or limiting fluid intake are not specific instructions related to minimizing the side effect of oral candidiasis associated with Beclomethasone.

5. A client has a new prescription for Warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, not potassium. Therefore, the client needs to be cautious with foods high in vitamin K, such as green leafy vegetables, rather than foods high in potassium. Choices A, B, and D are correct statements regarding Warfarin therapy and do not indicate a need for further teaching.

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