Nursing Elites

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

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction to include when a client is prescribed Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these adverse effects and ensures the client's safety. Option A is incorrect because Furosemide is usually taken in the morning to prevent disturbed sleep due to frequent urination. Option B is incorrect as Furosemide can cause potassium loss, so advising to avoid foods high in potassium would not be appropriate. Option D is incorrect because taking Furosemide with meals may increase the risk of side effects and decrease its effectiveness.

2. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.

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

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: Corrected Rationale: Enalapril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. The nurse should closely monitor the client for this and instruct them to report it to the healthcare provider if it occurs. Choices B, C, and D are incorrect as weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

4. What is a severe adverse effect of warfarin?

• A. Bleeding
• B. Arrhythmias
• C. Blurred vision
• D. Bradycardia

Correct answer: A

Rationale: A severe adverse effect of warfarin is bleeding. Warfarin is an anticoagulant medication that works by inhibiting blood clotting factors, which can lead to an increased risk of bleeding. Excessive bleeding can occur internally or externally, and it is crucial for individuals taking warfarin to be aware of this potential complication and seek medical attention if they experience any signs of bleeding. Arrhythmias, blurred vision, and bradycardia are not typically associated with warfarin use, making them incorrect choices.

5. A client has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?

• A. Take the medication with food.
• B. Plan to take the medication at bedtime.
• C. Expect increased swelling of the ankles.
• D. Limit fluid intake in the morning.

Correct answer: A

Rationale: When educating a client about taking Hydrochlorothiazide, the nurse should advise taking the medication with food or after meals to prevent gastrointestinal upset. This medication is a diuretic, so it is important to maintain adequate fluid intake throughout the day to prevent dehydration. Taking it at bedtime is not necessary, and increased swelling of the ankles is not an expected side effect of this medication. Limiting fluid intake in the morning is not necessary and could lead to dehydration, which is a potential side effect of this diuretic.

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