Nursing Elites

1. A client with diabetes mellitus type 2 is prescribed pioglitazone. The nurse should monitor for which potential adverse effect?

• A. Weight gain
• B. Liver toxicity
• C. Kidney stones
• D. Bone fractures

Correct answer: B

Rationale: The correct answer is B, liver toxicity. Pioglitazone is known to cause liver toxicity, so it is essential for the nurse to monitor the client's liver function while on this medication. Monitoring liver function tests can help detect any signs of liver damage early, allowing for timely intervention to prevent serious complications.

2. A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?

• A. The client is experiencing vision and hearing loss.
• B. The client has an erection lasting longer than 4 hours.
• C. The client is complaining of nasal congestion.
• D. The client is complaining of feeling flushed.

Correct answer: A

Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications. Choices B, C, and D are incorrect because an erection lasting more than 2 hours (not 4 hours as stated in choice B) is a critical adverse effect that warrants immediate medical attention. Nasal congestion (choice C) and feeling flushed (choice D) are common side effects of sildenafil and typically do not necessitate immediate discontinuation of the medication or emergency intervention.

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

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

Correct answer: A

Rationale: The correct answer is A: Hypotension. Clonidine, a medication used to treat hypertension, can cause a lowering of blood pressure leading to hypotension as a potential side effect. Monitoring for hypotension is essential to prevent complications such as dizziness, fainting, or falls. Option B, Tachycardia, is incorrect as clonidine typically causes bradycardia or a decreased heart rate. Option C, Dizziness, can occur due to hypotension caused by clonidine. Option D, Hyperglycemia, is not a common side effect associated with clonidine use.

4. How should the healthcare provider schedule the administering of propylthiouracil (PTU)?

• A. Offer both drugs together with a meal
• B. Give parental dose once every 24 hours
• C. Schedule both medications at bedtime
• D. Administer iodine one hour before PTU

Correct answer: D

Rationale: Administering iodine one hour before PTU is crucial to ensure proper absorption and effectiveness of PTU. This timing helps optimize the therapeutic benefits of PTU by allowing it to be absorbed efficiently without interference from iodine, ultimately leading to better treatment outcomes for the patient. Choices A, B, and C are incorrect because offering both drugs together with a meal, giving parental dose once every 24 hours, and scheduling both medications at bedtime do not address the specific timing requirement of administering iodine before PTU for optimal absorption.

5. A client with heart failure develops hyperaldosteronism. What dietary recommendation is essential for managing this condition?

• A. Limit intake of high potassium foods
• B. Replace salt with salt substitute
• C. Monitor skin for excessive bruising
• D. Cover your skin before going outside

Correct answer: A

Rationale: Hyperaldosteronism can lead to increased potassium retention, which can be problematic for individuals with heart failure. Limiting intake of high potassium foods is crucial to prevent hyperkalemia, a condition that can worsen heart failure. Therefore, advising the client to limit high potassium foods is essential in managing hyperaldosteronism in the setting of heart failure.

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