Nursing Elites

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

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

Correct answer: A

Rationale: Corrected Rationale: Valsartan is an angiotensin II receptor blocker (ARB) that can cause hyperkalemia by affecting the renin-angiotensin-aldosterone system. The nurse should closely monitor the client's potassium levels due to the risk of hyperkalemia, which can lead to serious cardiac complications. Choice B, hypoglycemia, is not a common adverse effect of Valsartan. Choice C, bradycardia, is not directly associated with Valsartan use. Choice D, hypercalcemia, is not a typical adverse effect of Valsartan.

2. Before administering lithium to a client with bipolar disorder who has been taking the medication for 1 year, the nurse should check to see that which of the following tests has been completed?

• A. Thyroid hormone assay
• B. Liver function tests
• C. Erythrocyte sedimentation rate
• D. Brain natriuretic peptide

Correct answer: A

Rationale: The correct answer is to check the thyroid hormone assay. Long-term lithium use can result in thyroid dysfunction, making it crucial to monitor the client's thyroid function regularly to detect any abnormalities early and prevent potential complications. Liver function tests (choice B) are not specifically associated with lithium therapy. Erythrocyte sedimentation rate (choice C) is a nonspecific test for inflammation and not directly related to lithium therapy. Brain natriuretic peptide (choice D) is a test used to diagnose heart failure and is not relevant to monitoring lithium therapy.

3. A client with schizophrenia is being taught strategies to cope with anticholinergic effects of Fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?

• A. Take the medication in the morning to prevent insomnia.
• B. Chew sugarless gum to moisten the mouth.
• C. Use cooling measures to decrease fever.
• D. Take an antacid to relieve nausea.

Correct answer: B

Rationale: Chewing sugarless gum is an effective strategy to manage dry mouth, a common anticholinergic effect of Fluphenazine. By stimulating saliva production, sugarless gum helps to moisten the mouth and alleviate the discomfort associated with dryness. This intervention can improve the client's oral health and overall comfort while taking the medication. The other options are not directly related to alleviating anticholinergic effects. Taking the medication in the morning to prevent insomnia does not address anticholinergic effects specifically. Using cooling measures to decrease fever is not relevant to managing dry mouth caused by anticholinergic effects. Taking an antacid to relieve nausea is unrelated to managing dry mouth, which is the focus of anticholinergic effects.

4. A client is starting a new prescription for ferrous sulfate. Which of the following instructions should the nurse include?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Take the medication with orange juice to enhance absorption.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct answer is C: 'Take the medication with orange juice to enhance absorption.' Taking ferrous sulfate with orange juice helps enhance the absorption of iron due to the ascorbic acid present in the orange juice, which aids in iron absorption. This combination can help improve the effectiveness of the medication. Choice A, taking the medication with meals, may reduce gastrointestinal side effects but does not specifically enhance absorption. Choice B, taking the medication on an empty stomach, may lead to better absorption but can also increase the risk of gastrointestinal side effects. Choice D, taking the medication with a full glass of milk, is incorrect because calcium in milk can inhibit the absorption of iron.

5. When teaching a client with a prescription for long-term use of oral prednisone for chronic asthma, the nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: The correct answer is weight gain. Weight gain and fluid retention are common adverse effects of oral prednisone due to sodium and water retention. Patients on long-term prednisone therapy should be advised to monitor their weight closely and report any significant changes to their healthcare provider. Choice B, 'Nervousness,' is not typically associated with oral prednisone use. Choice C, 'Bradycardia,' refers to a slow heart rate, which is not a common adverse effect of prednisone. Choice D, 'Constipation,' is not a typical adverse effect of oral prednisone; instead, gastrointestinal disturbances like increased appetite or even peptic ulcer disease may occur.

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