Nursing Elites

1. A client has a new prescription for Hydrochlorothiazide. Which of the following adverse effects should the nurse monitor?

• A. Hyponatremia
• B. Hyperkalemia
• C. Hypercalcemia
• D. Hypoglycemia

Correct answer: A

Rationale: Corrected Rationale: Hydrochlorothiazide is a diuretic known to cause electrolyte imbalances, particularly hyponatremia (low sodium levels). The nurse should closely monitor the client for signs of hyponatremia by assessing their electrolyte levels. Choice B, Hyperkalemia, is incorrect as hydrochlorothiazide is more likely to cause hypokalemia (low potassium levels) rather than hyperkalemia. Choice C, Hypercalcemia, is incorrect because hydrochlorothiazide is not known to cause increased calcium levels. Choice D, Hypoglycemia, is also incorrect as it is not a common adverse effect of hydrochlorothiazide.

2. Potassium-sparing diuretics primarily affect which part of the kidney?

• A. Proximal convoluted tubule
• B. Loop of Henle
• C. Collecting duct
• D. Distal convoluted tubule

Correct answer: D

Rationale: Potassium-sparing diuretics exert their primary effects on the distal convoluted tubule in the kidney. By acting on this specific part of the nephron, these diuretics promote sodium excretion while sparing potassium, thus helping to maintain potassium levels in the body. This mechanism differs from other diuretics that may cause potassium loss as a side effect. Understanding the site of action of potassium-sparing diuretics is crucial in clinical practice for managing conditions like hypertension and edema where diuresis is necessary without the risk of hypokalemia.

3. A client has a new prescription for Oxycodone/Acetaminophen, and the nurse is providing discharge instructions. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid taking additional Acetaminophen while on this medication.
• C. Increase your intake of fiber while on this medication.
• D. Avoid taking the medication before bedtime.

Correct answer: B

Rationale: The correct instruction for a client with a prescription for Oxycodone/Acetaminophen is to avoid taking additional Acetaminophen while on this medication. Combining medications containing Acetaminophen can lead to exceeding the maximum recommended dose and increase the risk of liver toxicity. Therefore, it is crucial for the nurse to emphasize the importance of not taking extra Acetaminophen while on this prescription to ensure the client's safety and well-being. Choices A, C, and D are incorrect. Taking Oxycodone/Acetaminophen on an empty stomach is not necessary; increasing fiber intake is not directly related to this medication, and avoiding taking the medication before bedtime is not a specific concern associated with this prescription.

4. A healthcare professional working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the healthcare professional's priority?

• A. Administer flumazenil.
• B. Identify the client's level of orientation.
• C. Infuse IV fluids.
• D. Prepare the client for gastric lavage.

Correct answer: B

Rationale: When managing a client with Benzodiazepine toxicity, the priority action for the healthcare professional is to assess the client. Identifying the client's level of orientation allows the healthcare professional to understand the client's cognitive status, which is crucial for further interventions and decision-making in the care plan. Administering flumazenil (Choice A) may precipitate withdrawal symptoms and should be done cautiously. Infusing IV fluids (Choice C) can be important but is not the priority over assessing the client. Gastric lavage (Choice D) is not typically recommended due to the risk of complications and its limited effectiveness in cases of Benzodiazepine overdose.

5. A client with cancer and a prescription for methotrexate PO reports bleeding gums while being assessed by a nurse in a provider's clinic. Which of the following actions should the nurse take?

• A. Explain to the client that this is an expected adverse effect.
• B. Check the value of the client's current platelet count.
• C. Instruct the client to use an electric toothbrush.
• D. Have the client make an appointment to see the dentist.

Correct answer: B

Rationale: The correct action for the nurse to take when a client on methotrexate reports bleeding gums is to check the client's current platelet count. Bleeding gums may indicate thrombocytopenia, a decreased platelet count which can be a severe side effect of methotrexate therapy. Monitoring the platelet count is crucial for early detection and management of this potentially life-threatening complication. Choice A is incorrect as bleeding gums in this context may not be an expected adverse effect of methotrexate. Choice C is irrelevant and does not address the potential underlying issue of thrombocytopenia. Choice D is not the primary action needed at this point; checking the platelet count is more urgent to assess the severity of the situation.

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