Nursing Elites

1. A client with chronic kidney disease is prescribed sucroferric oxyhydroxide. What potential side effect should the nurse monitor for?

• A. Diarrhea
• B. Constipation
• C. Nausea
• D. Hyperphosphatemia

Correct answer: A

Rationale: Sucroferric oxyhydroxide is known to cause diarrhea as a side effect. Therefore, the nurse should closely monitor the client for any signs of diarrhea while on this medication to ensure timely intervention and management.

2. A client vomits 30 minutes after receiving a dose of hydromorphone on the first postoperative day. What initial intervention is best for the practical nurse (PN) to implement?

• A. Obtain a prescription for nasogastric intubation.
• B. Administer a prn dose of ondansetron.
• C. Reduce the next scheduled dose of hydromorphone.
• D. Assess the client's abdomen and bowel sounds.

Correct answer: B

Rationale: In this scenario, the client's vomiting is likely due to the hydromorphone administration, indicating a need for an antiemetic such as ondansetron to address the nausea. Nasogastric intubation (Choice A) is not necessary at this point as the client is vomiting, not experiencing an obstruction. While reducing the dose of hydromorphone (Choice C) may be considered later, the immediate focus should be managing the client's symptoms. Assessing the client's abdomen and bowel sounds (Choice D) can be important but is not the initial priority when addressing the vomiting post hydromorphone administration.

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

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

Correct answer: A

Rationale: The correct answer is A: Hypotension. Valsartan is an angiotensin II receptor blocker that can cause hypotension as a side effect by dilating blood vessels. Monitoring blood pressure is crucial to prevent complications related to low blood pressure. Choice B, Tachycardia, is incorrect because valsartan typically does not cause an increase in heart rate. Choice C, Hyperglycemia, is not a common side effect of valsartan. Choice D, Hyponatremia, is also unlikely with valsartan use.

4. A client with chronic kidney disease is prescribed lanthanum carbonate. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: Lanthanum carbonate is prescribed in chronic kidney disease to bind dietary phosphorus in the gastrointestinal tract. This action can lead to decreased phosphorus absorption and potential hypercalcemia due to the increased serum calcium levels. Therefore, the nurse should monitor the client for signs and symptoms of hypercalcemia, such as confusion, fatigue, and muscle weakness. Choices B, C, and D are incorrect as lanthanum carbonate's mechanism of action does not lead to hypocalcemia, hyperkalemia, or hypokalemia.

5. A client with rheumatoid arthritis is prescribed sulfasalazine. Which instruction should the nurse include in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid sunlight while taking this medication.
• C. Report any signs of infection to the healthcare provider.
• D. Take this medication on an empty stomach.

Correct answer: A

Rationale: The correct instruction to include in the client's teaching plan regarding sulfasalazine is to take the medication with meals. Taking sulfasalazine with food helps to minimize gastrointestinal upset, which is a common side effect of the medication. Choice B is incorrect because avoiding sunlight is not specifically related to sulfasalazine. Choice C is important but not directly related to the administration of sulfasalazine. Choice D is incorrect because sulfasalazine should be taken with meals to reduce gastrointestinal side effects.

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