Nursing Elites

1. A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.

2. A client in a coronary care unit is being admitted after CPR post cardiac arrest. The client is receiving IV lidocaine at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions?

• A. Prevents dysrhythmias
• B. Slows intestinal motility
• C. Dissolves blood clots
• D. Relieves pain

Correct answer: A

Rationale: Lidocaine is administered to prevent dysrhythmias by delaying conduction in the heart and reducing the automaticity of heart tissue. This action helps stabilize the heart's electrical activity and prevent life-threatening arrhythmias post-cardiac arrest. Choices B, C, and D are incorrect as lidocaine is not used for slowing intestinal motility, dissolving blood clots, or relieving pain in this context.

3. A nurse is caring for a client in an outpatient facility who has been taking Acarbose for type 2 Diabetes Mellitus. Which of the following laboratory tests should the nurse plan to monitor?

• A. WBC
• B. Serum potassium
• C. Platelet count
• D. Liver function test

Correct answer: D

Rationale: The correct answer is D, Liver function test. Acarbose can cause liver toxicity when taken long-term. Monitoring liver function tests periodically is essential to assess for any potential liver damage. Choices A, B, and C are incorrect because Acarbose does not directly impact white blood cell count, serum potassium levels, or platelet count.

4. A healthcare provider is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare provider should monitor the client for which of the following as an adverse effect of this medication?

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

Correct answer: B

Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, leading to potassium retention. Monitoring potassium levels is essential to prevent complications associated with hyperkalemia. Bradycardia (Choice A) is not a common adverse effect of Enalapril. Enalapril does not typically affect glucose levels, so hypoglycemia (Choice C) is not a common concern with this medication. Enalapril does not directly impact calcium levels, so hypocalcemia (Choice D) is not a typical adverse effect.

5. A client is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Monitoring blood pressure is crucial to detect and manage hypertension promptly. Leukocytosis refers to an increased white blood cell count and is not directly related to epoetin alfa treatment. Hyperkalemia is an elevated potassium level, which is not a common adverse effect of epoetin alfa. Fever is not a typical finding associated with epoetin alfa therapy.

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