Nursing Elites

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

• A. Cough
• B. Dizziness
• C. Hyperkalemia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Cough. Lisinopril is known to cause a persistent dry cough as a side effect. It is essential for the nurse to monitor the client for this adverse reaction as it may lead to discontinuation of the medication. Dizziness, hyperkalemia, and hyponatremia are not typically associated with lisinopril use. Dizziness is more commonly seen with antihypertensives that cause orthostatic hypotension. Hyperkalemia and hyponatremia are not usually linked to lisinopril use.

2. A female client who started chemotherapy three days ago for cancer of the breast calls the clinic reporting that she is so upset she cannot sleep. The client has several PRN medications available. Which drug should the nurse instruct her to take?

• A. Ondansetron 8mgPO no
• B. Lorazepam 2mg PO bedtime
• C. Oxycodone, acetylsalicylic acid one tablet q4 hours PRN
• D. Acetaminophen, diphenhydramine 2 capsules bedtime

Correct answer: D

Rationale: Acetaminophen and diphenhydramine help with sleep without severe side effects.

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

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to an excess of potassium in the body, causing hyperkalemia. This medication inhibits the action of aldosterone, leading to decreased potassium excretion and potential retention. Monitoring potassium levels is essential to prevent complications such as cardiac arrhythmias, especially in clients with heart failure.

4. An adolescent client with a seizure disorder is prescribed the anticonvulsant medication carbamazepine. The nurse should notify the healthcare provider if the client develops which condition?

• A. Experiences dry mouth.
• B. Experiences dizziness.
• C. Develops a sore throat.
• D. Develops gingival hyperplasia.

Correct answer: C

Rationale: The correct answer is C: 'Develops a sore throat.' When a client on carbamazepine develops flu-like symptoms such as pallor, fatigue, sore throat, and fever, it could indicate blood dyscrasias (aplastic anemia, leukopenia, anemia, thrombocytopenia), which are potential adverse effects of the medication. These symptoms warrant immediate notification of the healthcare provider for further evaluation and management to prevent complications. Choices A, B, and D are incorrect because dry mouth, dizziness, and gingival hyperplasia are not commonly associated with carbamazepine use and do not indicate serious adverse effects that require immediate healthcare provider notification.

5. A client with rheumatoid arthritis is prescribed methotrexate. The nurse should monitor for which common side effect of this medication?

• A. Liver toxicity
• B. Skin rash
• C. Hair loss
• D. Abdominal pain

Correct answer: A

Rationale: The correct answer is A: Liver toxicity. Methotrexate is known to cause liver toxicity, making regular monitoring of liver function essential. Monitoring liver function tests helps detect any signs of liver damage early, allowing for appropriate interventions to be implemented promptly.

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