Nursing Elites

1. A client has a new prescription for Verapamil to treat angina. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of Verapamil?

• A. I am frequently constipated.
• B. I have been urinating more frequently.
• C. My skin is peeling.
• D. I have ringing in my ears.

Correct answer: A

Rationale: The correct answer is A: 'I am frequently constipated.' Constipation is a common adverse effect of Verapamil, a calcium channel blocker. Verapamil can slow down intestinal motility, leading to constipation as a side effect. Choices B, C, and D are not typically associated with adverse effects of Verapamil. Increased urination is not a common side effect, skin peeling is not related to Verapamil use, and ringing in the ears is not a typical adverse effect of this medication.

2. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients who develop tachycardia, such as in the case of reflex tachycardia induced by Isosorbide Mononitrate, making it the appropriate choice in this scenario. Furosemide (Choice A) is a loop diuretic used for conditions like heart failure and edema, not for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor primarily used for hypertension and heart failure, not for reflex tachycardia. Ranolazine (Choice C) is used for chronic angina but does not specifically address reflex tachycardia.

3. Medications classified as angiotensin II receptor agents typically end in?

• A. Sartan
• B. Ase
• C. Olol
• D. Pril

Correct answer: A

Rationale: Angiotensin II receptor agents belong to the drug class called angiotensin II receptor blockers (ARBs). The generic names of ARBs usually end in -sartan, helping to identify this specific class of medications. Therefore, medications that end in -sartan are likely to be angiotensin II receptor agents. Choices B, C, and D are incorrect because drugs ending in -ase (like streptokinase), -olol (like propranolol), and -pril (like lisinopril) typically belong to different drug classes with distinct mechanisms of action.

4. When providing teaching to a client with a prescription for Hydrochlorothiazide, which instruction should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct instruction for a client prescribed Hydrochlorothiazide is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and electrolyte imbalance, potentially causing dehydration. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. Therefore, it is essential for the client to be vigilant in recognizing these symptoms and seek medical attention if they occur. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide at bedtime is not a specific instruction related to its effects or side effects. Avoiding foods high in potassium may be necessary for some medications, but it is not the primary concern with Hydrochlorothiazide. Taking this medication on an empty stomach is not a requirement and may vary depending on individual preferences or healthcare provider instructions.

5. An older adult client has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity?

• A. Phenytoin
• B. Verapamil
• C. Warfarin
• D. Aluminum hydroxide

Correct answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to toxicity. When given together, the digoxin dosage may need adjustment, and the nurse should closely monitor the client's digoxin levels to prevent toxicity symptoms such as nausea, vomiting, visual disturbances, and arrhythmias. The other choices, Phenytoin, Warfarin, and Aluminum hydroxide, do not significantly interact with Digoxin to cause toxicity. Phenytoin may reduce Digoxin levels, while Warfarin and Aluminum hydroxide have minimal interactions with Digoxin.

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