Nursing Elites

1. A client with a history of heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to an excess of potassium in the body, causing hyperkalemia. This medication inhibits the action of aldosterone, leading to decreased potassium excretion and potential retention. Monitoring potassium levels is essential to prevent complications such as cardiac arrhythmias, especially in clients with heart failure.

2. What is the primary nursing intervention that the practical nurse should perform before administering ampicillin to a client diagnosed with a urinary tract infection?

• A. Obtain a clean-catch urine specimen.
• B. Assess the urine pH for acidity.
• C. Insert an indwelling catheter.
• D. Assess for complaints of dysuria.

Correct answer: A

Rationale: The correct answer is to obtain a clean-catch urine specimen. Before administering ampicillin to a client with a urinary tract infection, it is crucial to collect a urine specimen to determine the causative organism and evaluate the effectiveness of pharmacological therapy. Assessing the urine pH for acidity (choice B) is not the primary intervention needed before administering ampicillin. Inserting an indwelling catheter (choice C) is invasive and not necessary unless indicated for specific reasons. Assessing for complaints of dysuria (choice D) is important but does not take precedence over obtaining a urine specimen for proper diagnosis and treatment.

3. A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?

• A. Take the medication at the same time every day.
• B. Discontinue the medication if a rash develops.
• C. Avoid consuming dairy products.
• D. Monitor blood pressure regularly.

Correct answer: A

Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin. Choices B, C, and D are incorrect because discontinuing the medication without healthcare provider guidance can be dangerous, there is no specific interaction between phenytoin and dairy products, and monitoring blood pressure is not a primary concern with phenytoin therapy for seizures.

4. A client with a history of hypertension is prescribed hydrochlorothiazide. The practical nurse should monitor the client for which potential adverse effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: B

Rationale: Corrected Rationale: Hydrochlorothiazide is a diuretic that can lead to potassium loss, resulting in hypokalemia. Monitoring for hypokalemia is essential because it can cause various complications such as cardiac dysrhythmias. Therefore, the practical nurse should closely watch for signs and symptoms of low potassium levels in clients taking hydrochlorothiazide. Incorrect Rationale for Other Choices: A. Hyperkalemia is not typically associated with hydrochlorothiazide use; instead, it is more commonly linked to medications like ACE inhibitors or potassium-sparing diuretics. C. Hypernatremia is unlikely with hydrochlorothiazide use as it tends to cause sodium loss. D. Hyponatremia is more commonly associated with conditions where there is excessive water intake or syndrome of inappropriate antidiuretic hormone secretion (SIADH), rather than with hydrochlorothiazide use.

5. A client with a history of stroke is prescribed warfarin. The nurse should monitor for which potential side effect?

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Bleeding. Warfarin is an anticoagulant medication that works by thinning the blood. One of the potential side effects of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as unusual bruising, blood in the urine or stool, or prolonged bleeding from cuts or gums. Prompt recognition and management of bleeding are essential to prevent complications. Choices B, C, and D are incorrect as weight gain, headache, and dizziness are not common side effects of warfarin. Monitoring for bleeding is a priority due to the anticoagulant properties of warfarin.

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