Nursing Elites

1. 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.

2. A client with a history of heart failure is prescribed carvedilol. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: When a client is prescribed carvedilol, the nurse should monitor for bradycardia, a potential side effect of this medication. Carvedilol is a beta-blocker that can slow down the heart rate, so monitoring for signs of bradycardia is essential to prevent any adverse effects on the client's cardiovascular system. Tachycardia (Choice B) is less likely to occur with carvedilol since it primarily works to reduce heart rate. Hypertension (Choice C) and hyperglycemia (Choice D) are not common side effects associated with carvedilol.

3. 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.

4. A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines the client has been self-administering St. John's wort, an herbal preparation, on the advice of a friend. What information is most significant about this finding?

• A. Wort can decrease plasma concentration of Cyclospora
• B. Wort can decrease plasma concentration of Tacrolimus
• C. Wort can decrease plasma concentration of Cyclosporine
• D. Wort can decrease plasma concentration of Mycophenolate

Correct answer: C

Rationale: The most significant information about the client self-administering St. John's wort, an herbal preparation, is that it can decrease the plasma concentration of Cyclosporine. St. John's wort is known to reduce the efficacy of Cyclosporine, which is a common immunosuppressant drug used to prevent transplant rejection. Choices A, B, and D are incorrect because St. John's wort does not affect the plasma concentration of Cyclospora, Tacrolimus, or Mycophenolate.

5. A client with osteoporosis is prescribed alendronate. The practical nurse (PN) should reinforce which instruction regarding the administration of this medication?

• A. Take the medication with a full glass of water before breakfast.
• B. Take the medication immediately after a meal.
• C. Lie down for 30 minutes after taking the medication.
• D. Crush the medication and mix it with food.

Correct answer: A

Rationale: The correct instruction for administering alendronate is to take the medication with a full glass of water before breakfast. This timing is crucial to ensure proper absorption in the body and reduce the risk of esophageal irritation. Taking it immediately after a meal or lying down for 30 minutes after may affect absorption and increase the risk of adverse effects. It should not be crushed or mixed with food to maintain its effectiveness.

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