Nursing Elites

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

• A. Take the medication with food.
• B. Monitor your blood pressure weekly.
• C. Notify your provider if you develop a persistent cough.
• D. Avoid using salt substitutes to prevent hyperkalemia.

Correct answer: C

Rationale: Clients prescribed with Captopril, an ACE inhibitor, are at risk of developing a persistent cough as a common adverse effect. It is essential for the client to inform their healthcare provider promptly if this side effect occurs to evaluate the need for a medication change or adjustment.

2. A healthcare provider is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The provider should recognize which of the following conditions is a contraindication for taking propranolol?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Asthma. Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, making it contraindicated in clients with asthma. Using propranolol in asthma can exacerbate bronchoconstriction and potentially lead to respiratory distress or exacerbation of asthma symptoms. Choices B, C, and D are incorrect. Glaucoma, hypertension, and tachycardia are not contraindications for taking propranolol. In fact, propranolol is commonly used to treat hypertension and tachycardia.

3. A client is receiving spironolactone. Which of the following findings should the nurse report to the provider?

• A. Serum Sodium 144 mEq/L
• B. Urine output 120 mL in 4 hrs
• C. Serum Potassium 5.2 mEq/L
• D. Blood Pressure 140/90 mmHg

Correct answer: C

Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to potassium retention. The nurse should notify the provider and withhold the medication to prevent further elevation of potassium levels, which can result in serious cardiac complications. The other findings (Serum Sodium 144 mEq/L, Urine output 120 mL in 4 hrs, and Blood Pressure 140/90 mmHg) are within normal ranges and not directly related to spironolactone therapy.

4. A client has been prescribed Methotrexate to treat Rheumatoid Arthritis. Which of the following instructions should the nurse provide?

• A. Take this medication with food to prevent nausea.
• B. Avoid alcohol while taking this medication.
• C. Wear sunscreen when outdoors while taking this medication.
• D. Take this medication on an empty stomach.

Correct answer: B

Rationale: Methotrexate is hepatotoxic, and avoiding alcohol is crucial to prevent liver damage. However, Option A (Take this medication with food to prevent nausea) could also be correct, as Methotrexate commonly causes nausea, and taking it with food can help alleviate this side effect. However, the most important instruction is to avoid alcohol due to the risk of liver toxicity.

5. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.

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