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 is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Administer Propranolol to decrease the client's blood pressure.
• C. Assist the client with sitting up or standing after taking this medication.
• D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.

3. A patient with hypertension is taking an ACE inhibitor to lower blood pressure. What should the nurse advise the patient to avoid in their diet?

• A. Vinegar
• B. Apples
• C. Salt substitutes
• D. Tomatoes

Correct answer: C

Rationale: Patients taking ACE inhibitors should avoid salt substitutes as they often contain potassium, which can lead to hyperkalemia. Hyperkalemia is an elevated level of potassium in the blood that can be dangerous, especially for patients on ACE inhibitors. Vinegar, apples, and tomatoes do not pose a risk for patients taking ACE inhibitors. Therefore, the nurse should advise the patient to avoid salt substitutes to prevent potential complications.

4. A client has a new prescription for Atorvastatin. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the blood levels of Atorvastatin by inhibiting its metabolism in the body, leading to a higher risk of adverse effects, such as muscle pain and liver damage. Therefore, it is important for the client to avoid consuming grapefruit juice while taking Atorvastatin. Choices A, C, and D are incorrect because Atorvastatin can be taken with or without food, at any time of the day, and there is no specific need to increase potassium-rich foods while on this medication.

5. A healthcare professional is preparing to administer vancomycin to a client. The professional should monitor for which of the following adverse effects?

• A. Nephrotoxicity
• B. Hepatotoxicity
• C. Red Man Syndrome
• D. Diarrhea

Correct answer: C

Rationale: Red Man Syndrome is a common adverse effect of vancomycin characterized by flushing and rash. It is not related to nephrotoxicity, hepatotoxicity, or diarrhea. Monitoring for this reaction allows for prompt intervention to prevent severe complications.

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