Nursing Elites

1. A client with chronic heart failure is prescribed furosemide. The nurse should monitor the client for which potential adverse effect?

• A. Increased blood glucose levels
• B. Electrolyte imbalance
• C. Dehydration
• D. Weight gain

Correct answer: C

Rationale: When a client with chronic heart failure is prescribed furosemide, a diuretic, the nurse should be vigilant for potential adverse effects. Furosemide can lead to excessive fluid loss, resulting in dehydration. Dehydration is a significant concern as it can exacerbate heart failure symptoms. Additionally, furosemide can cause electrolyte imbalances, particularly affecting potassium and sodium levels. Monitoring for signs of dehydration and electrolyte disturbances is crucial to prevent complications and ensure the client's safety and well-being. Increased blood glucose levels and weight gain are not commonly associated with furosemide use in heart failure patients, making choices A and D incorrect.

2. A client with epilepsy is prescribed lamotrigine. The nurse should monitor for which potential side effect?

• A. Drowsiness
• B. Nausea and vomiting
• C. Skin rash
• D. Dizziness

Correct answer: C

Rationale: When a client is prescribed lamotrigine, the nurse should closely monitor for the potential side effect of skin rash. Lamotrigine is known to cause skin rashes, which can be mild or severe, indicating a serious adverse reaction like Stevens-Johnson syndrome. Monitoring for skin rash is crucial to detect any signs of severe allergic reactions early and prevent further complications. Choices A, B, and D are incorrect as drowsiness, nausea and vomiting, and dizziness are not typically associated with lamotrigine use. While dizziness can be a side effect of some antiepileptic medications, it is not a common side effect of lamotrigine.

3. A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer the requested medication, the client is seen talking and laughing with visiting family. What action should the PN take?

• A. Hold the pain medication until after the visitors leave.
• B. Notify the healthcare provider of the client's drug-seeking behavior.
• C. Administer analgesia as requested by the client.
• D. Inform the client that the medication is not needed based on their behavior.

Correct answer: C

Rationale: The correct action for the PN in this situation is to administer the analgesia as requested by the client. Pain management is based on the client's self-report of pain, which is the most reliable indicator of pain intensity. Analgesics should be given promptly when pain occurs and before it worsens. Following the administration of medication, the PN should discuss the situation with the charge nurse for further guidance or assessment.

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

• A. Bradycardia
• B. Tachycardia
• C. Hypotension
• D. Hyperglycemia

Correct answer: A

Rationale: When a client is prescribed atenolol, a beta-blocker medication used to treat hypertension, the nurse should monitor for bradycardia as a potential side effect. Atenolol works by slowing the heart rate, and one common adverse effect is bradycardia, which is a slower than normal heart rate. Monitoring the client's heart rate is essential to detect and manage this potential side effect promptly. Choices B, C, and D are incorrect because atenolol typically does not cause tachycardia, hypotension, or hyperglycemia as primary side effects. Instead, bradycardia is a common concern due to the drug's mechanism of action in reducing heart rate.

5. A client whose seizure disorder has been managed with phenytoin is admitted to the emergency department with status epilepticus. Which drug should the practical nurse anticipate being prescribed for administration to treat these seizures?

• A. Phenytoin
• B. Diazepam
• C. Phenobarbital
• D. Carbamazepine

Correct answer: B

Rationale: In the management of status epilepticus, which is a life-threatening condition of prolonged seizures, rapid intervention is crucial. Diazepam is the drug of choice for treating status epilepticus due to its fast onset of action and effectiveness in stopping seizures. It acts by enhancing the inhibitory neurotransmitter GABA to suppress seizure activity quickly. Phenytoin, although used for long-term seizure control, has a slower onset of action and is not the first-line medication for managing status epilepticus.

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