Nursing Elites

1. A client with asthma is receiving long-term glucocorticoid therapy. The nurse includes a risk for impaired skin integrity on the client's problem list. What is the rationale for including this problem?

• A. Abnormal fat deposits impair circulation
• B. Frequent diarrhea can lead to skin issues
• C. Thinned skin bruises easily
• D. Decreased serum glucose prolongs healing time

Correct answer: C

Rationale: The correct answer is C. Glucocorticoids can cause skin thinning, which increases the likelihood of bruising. Thinning of the skin due to glucocorticoid therapy makes it more fragile and prone to injury, such as bruising, even with minimal trauma. Choices A, B, and D are incorrect because abnormal fat deposits impairing circulation, frequent diarrhea causing skin issues, and decreased serum glucose prolonging healing time are not direct effects of glucocorticoid therapy on skin integrity.

2. A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?

• A. Increased appetite
• B. Dry mouth and increased thirst
• C. Tremors and polyuria
• D. Constipation

Correct answer: B

Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.

3. A client taking long-term steroids also has ranitidine prescribed. The nurse provides which explanation as to why these drugs are given together?

• A. Ranitidine reduces the risk of ulcers associated with steroids.
• B. Ranitidine decreases the risk of infection associated with steroids.
• C. Ranitidine decreases blood sugar elevations associated with steroids.
• D. Ranitidine reduces sodium retention associated with steroid usage.

Correct answer: A

Rationale: The correct answer is A. Ranitidine is prescribed with long-term steroids to reduce the risk of ulcers associated with steroid therapy. Although steroids can increase the risk of ulcers due to their effect on the gastrointestinal system, ranitidine works by reducing stomach acid production, thus helping to prevent ulcer formation. Choices B, C, and D are incorrect as ranitidine is not given to decrease the risk of infection, reduce blood sugar elevations, or reduce sodium retention associated with steroid usage.

4. A 59-year-old client is prescribed furosemide 40 mg twice a day for the management of heart failure. The practical nurse should monitor the client for the development of which complication?

• A. Hypokalemia
• B. Hyperchloremia
• C. Hypercalcemia
• D. Hypophosphatemia

Correct answer: A

Rationale: Corrected Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and chloride in the kidneys, leading to increased potassium excretion and potentially causing hypokalemia. Hypokalemia can lead to cardiac irregularities, making it crucial for the practical nurse to monitor the client for this electrolyte imbalance. Choice B, Hyperchloremia, is not typically associated with furosemide use. Choices C and D, Hypercalcemia and Hypophosphatemia, are not common complications of furosemide therapy.

5. A client with hypertension is prescribed atenolol. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Dry mouth
• D. Hypotension

Correct answer: A

Rationale: When a client is prescribed atenolol, a beta-blocker, the nurse should monitor for bradycardia, which is a potential side effect. Atenolol works by slowing the heart rate, so monitoring the client's heart rate is essential to detect and manage bradycardia promptly.

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