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 Tetracycline. Which of the following instructions should be included?

• A. Take the medication with milk.
• B. Avoid prolonged sun exposure.
• C. Take the medication at bedtime.
• D. Expect urine to turn dark yellow.

Correct answer: B

Rationale: The correct instruction to include for a client prescribed Tetracycline is to 'Avoid prolonged sun exposure.' Tetracycline can cause photosensitivity, making the client more sensitive to the sun's rays. This can lead to adverse reactions like sunburn or skin rashes. Therefore, it is crucial for the client to minimize sun exposure and wear protective clothing when outdoors. Choice A is incorrect because taking Tetracycline with milk can reduce its absorption. Choice C is incorrect as there is no specific requirement to take Tetracycline at bedtime. Choice D is also incorrect as Tetracycline does not typically cause dark yellow urine.

3. A healthcare professional is preparing to administer furosemide 80 mg PO daily. The available furosemide oral solution is 10 mg/1 mL. How many mL should the healthcare professional administer?

• A. 8 mL
• B. 10 mL
• C. 6 mL
• D. 12 mL

Correct answer: A

Rationale: To determine the volume to administer, divide the desired dose by the available concentration. In this case, (80 mg / 10 mg/mL) = 8 mL. Therefore, the healthcare professional should administer 8 mL of furosemide oral solution. Choice B (10 mL), C (6 mL), and D (12 mL) are incorrect as they do not accurately calculate the volume needed based on the provided concentration of the solution.

4. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Dry cough.
• B. Hyperglycemia.
• C. Weight gain.
• D. Increased urination.

Correct answer: A

Rationale: The correct answer is A: Dry cough. A common adverse effect of Enalapril, an ACE inhibitor, is a persistent dry cough. This occurs due to the accumulation of bradykinin. It is essential for the client to monitor for this side effect and report it to their healthcare provider promptly. Choices B, C, and D are incorrect because hyperglycemia, weight gain, and increased urination are not typically associated with Enalapril use.

5. 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.

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