Nursing Elites

1. A client with chronic kidney disease is prescribed calcium acetate. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed calcium acetate, the nurse must monitor for hypercalcemia, not hypocalcemia, hyperkalemia, or hypokalemia. Calcium acetate can increase calcium levels in the blood, leading to hypercalcemia. Symptoms of hypercalcemia include fatigue, confusion, constipation, and muscle weakness. Regular monitoring of calcium levels is crucial to prevent complications associated with elevated calcium levels.

2. 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.

3. A client with rheumatoid arthritis is prescribed leflunomide. What instruction should the nurse include in the client's teaching plan?

• A. Avoid alcohol while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Avoid sunlight while taking this medication.
• D. Report any signs of infection to the healthcare provider.

Correct answer: A

Rationale: Leflunomide can increase sensitivity to sunlight. While it is important to avoid excessive sun exposure, the critical instruction for the client is to avoid alcohol while taking this medication. Alcohol can potentiate the hepatotoxic effects of leflunomide, making it crucial for the client to abstain from alcohol consumption to prevent liver damage.

4. When a client with hypertension is prescribed losartan, what potential side effect should the nurse monitor for?

• A. Hyperkalemia
• B. Dry cough
• C. Bradycardia
• D. Headache

Correct answer: B

Rationale: The correct answer is B: Dry cough. Losartan, an angiotensin II receptor blocker, can lead to a dry cough as a potential side effect. This occurs due to the drug's effect on the bradykinin pathway in the lungs. Monitoring for a dry cough is essential as it may indicate the need for further evaluation or medication adjustment to manage this adverse reaction.

5. What action should be taken six days after starting a prescription for oral amoxicillin solution?

• A. Determine if any other symptoms have developed
• B. Advise the use of over-the-counter antipyretics
• C. Instruct the client to increase oral fluid intake
• D. Ask if the medication has been kept refrigerated

Correct answer: A

Rationale: It is important to monitor for any new symptoms that may indicate a worsening condition or side effects when taking oral amoxicillin solution. This proactive approach helps in assessing the effectiveness and safety of the medication.

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