Nursing Elites

1. A client with heart failure is being instructed on laxative use. Which of the following laxatives should the client avoid?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: The correct answer is A: Sodium phosphate. Clients with heart failure often follow a sodium-restricted diet. Sodium phosphate laxatives can lead to sodium absorption, causing fluid retention, which is contraindicated in heart failure. It is crucial to avoid sodium phosphate laxatives in these clients to prevent exacerbation of fluid overload and heart failure symptoms. Psyllium (choice B), Bisacodyl (choice C), and Polyethylene glycol (choice D) are not contraindicated in clients with heart failure and can be used safely for bowel management.

2. A client has Diabetes Mellitus, Pulmonary Tuberculosis, and a new prescription for Isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH?

• A. Ascorbic acid
• B. Pyridoxine
• C. Folic acid
• D. Cyanocobalamin

Correct answer: B

Rationale: Pyridoxine is administered with Isoniazid to prevent peripheral neuropathy, a common adverse effect of the drug. It is essential to provide this supplement to the client to minimize the risk of developing this adverse effect. Ascorbic acid (Vitamin C) is not typically given to prevent INH adverse effects. Folic acid and Cyanocobalamin are not commonly administered with INH for this purpose.

3. A client has been prescribed Atorvastatin to lower cholesterol. Which of the following instructions should the nurse include?

• A. Take this medication with a full glass of water.
• B. Report any muscle pain to your provider immediately.
• C. Avoid drinking grapefruit juice while taking this medication.
• D. Take this medication at bedtime to prevent drowsiness.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to 'Report any muscle pain to your provider immediately.' Muscle pain can be a sign of rhabdomyolysis, a rare but serious side effect of statins like atorvastatin. It is crucial to monitor for potential complications, and reporting muscle pain promptly can lead to timely intervention if needed. Choices A, C, and D are incorrect because they do not address a critical side effect of atorvastatin or provide essential information for the client's safety and well-being.

4. When taking Digoxin, low levels of what can cause toxicity?

• A. Potassium
• B. Calcium
• C. Sodium
• D. Magnesium

Correct answer: A

Rationale: Low potassium levels can lead to Digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium pump. When potassium levels are low, there is an increased risk of Digoxin binding and toxicity. Choice B (Calcium) is incorrect because low calcium levels are not directly linked to Digoxin toxicity. Choice C (Sodium) is incorrect as low sodium levels do not cause Digoxin toxicity. Choice D (Magnesium) is incorrect as low magnesium levels do not contribute to Digoxin toxicity.

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

• A. Hypertension
• B. Edema
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Edema. Nifedipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should closely observe the client's lower extremities for any signs of swelling, which could indicate the development of edema. Choice A, Hypertension, is incorrect because Nifedipine is used to treat hypertension, not cause it. Choice C, Hyperglycemia, is unrelated to Nifedipine's common adverse effects. Choice D, Bradycardia, is not typically associated with Nifedipine use.

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