Nursing Elites

1. When teaching a client with a new prescription for furosemide, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for furosemide, a diuretic, is to take it in the morning to prevent nocturia. Taking it in the morning helps to prevent frequent urination during the night, allowing the client to have uninterrupted sleep. This timing also coincides with the body's natural diuretic response, which is typically more active during the day. Choices B, C, and D are incorrect because furosemide does not require avoiding foods high in potassium, taking it on an empty stomach, or limiting fluid intake to 1 liter per day.

2. A client with breast cancer is receiving cyclophosphamide. Which of the following findings should the nurse monitor?

• A. Hypertension
• B. Hyperglycemia
• C. Ototoxicity
• D. Hemorrhagic cystitis

Correct answer: D

Rationale: The nurse should monitor the client for hemorrhagic cystitis when receiving cyclophosphamide due to its potential to cause bladder irritation and lead to this serious adverse effect. It is essential to assess for symptoms such as hematuria, dysuria, and flank pain. Monitoring for hypertension, hyperglycemia, and ototoxicity is not directly related to the side effects of cyclophosphamide.

3. When assessing a client with chronic Neutropenia receiving Filgrastim, what action should the nurse take to evaluate for an adverse effect of the medication?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: The correct action when assessing a client receiving Filgrastim for chronic Neutropenia is to assess for bone pain. Bone pain is a known dose-related adverse effect of Filgrastim. Acetaminophen or opioid analgesics can be used to manage bone pain if necessary. Assessing for other types of pain, lung crackles, or heart murmurs would not be specific to the adverse effects of Filgrastim.

4. A healthcare professional in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?

• A. Calcium 9.2 mg/dL
• B. Calcium 10.3 mg/dL
• C. Potassium 3.4 mEq/L
• D. Potassium 4.8 mEq/L

Correct answer: C

Rationale: The correct answer is C: Potassium 3.4 mEq/L. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, especially in older clients taking Digoxin, as potassium plays a crucial role in the heart's electrical activity. Choices A and B are related to calcium levels, which do not directly increase the risk of Digoxin toxicity. Choice D, Potassium 4.8 mEq/L, is within the expected reference range and would not increase the risk of Digoxin toxicity.

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

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

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia due to its mechanism of action. Hyperkalemia can cause muscle weakness and cardiac dysrhythmias. Therefore, the nurse should educate the client to monitor for signs and symptoms of hyperkalemia while taking Spironolactone.

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