Nursing Elites

1. A client has a new prescription for Hydrochlorothiazide. Which of the following adverse effects should the nurse monitor?

• A. Hyponatremia
• B. Hyperkalemia
• C. Hypercalcemia
• D. Hypoglycemia

Correct answer: A

Rationale: Corrected Rationale: Hydrochlorothiazide, a diuretic, can lead to electrolyte imbalances, particularly hyponatremia (low sodium levels). The nurse should closely monitor the client's sodium levels due to the potential adverse effect of Hydrochlorothiazide. Incorrect Rationales: - Hyperkalemia (Choice B) is less likely to be caused by Hydrochlorothiazide; in fact, it can lead to hypokalemia. - Hypercalcemia (Choice C) is not a common adverse effect of Hydrochlorothiazide. - Hypoglycemia (Choice D) is not directly associated with Hydrochlorothiazide use.

2. A client with a new prescription for Verapamil to control hypertension is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?

• A. I should avoid drinking grapefruit juice.
• B. I can expect my heart rate to increase while taking this medication.
• C. This medication will cause my urine to turn orange.
• D. I will stop taking this medication if I experience headaches.

Correct answer: A

Rationale: The correct answer is A. Grapefruit juice can increase blood levels of verapamil, leading to increased effects and potentially serious side effects such as hypotension or bradycardia. It is crucial for the client to avoid grapefruit juice while taking Verapamil to prevent these adverse reactions. Choice B is incorrect because verapamil is a calcium channel blocker that typically lowers heart rate. Choice C is incorrect as verapamil does not cause urine discoloration. Choice D is incorrect because stopping medication abruptly without consulting a healthcare provider can be dangerous.

3. A client is starting therapy with filgrastim, and a nurse is providing teaching on monitoring adverse effects. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bone pain
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Bone pain. The nurse should instruct the client to monitor for bone pain since it is a common adverse effect of filgrastim. This occurs due to increased bone marrow activity stimulated by the medication.

4. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The correct action for the healthcare professional preparing to administer IV Hydromorphone to a client is to administer the medication over 5 minutes. This slow administration is crucial to reduce the risk of hypotension and respiratory depression. Administering the medication rapidly can lead to adverse effects. Option B, administering Naloxone prior to Hydromorphone, is incorrect because Naloxone is used as an antidote for opioid overdose, not as a routine pre-medication. Option C, assessing the client's blood pressure before administration, is important but not the immediate action to take to reduce adverse effects of Hydromorphone. Option D, injecting the medication into the client's subcutaneous tissue, is incorrect as Hydromorphone is meant for intravenous administration for rapid onset of action.

5. In caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT) and presents with a pulse rate of 98/min and blood pressure of 74/44 mm Hg, the nurse should anticipate a prescription for which of the following IV medications?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Magnesium sulfate

Correct answer: A

Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A). Sodium bicarbonate (Choice B) is not indicated for hypotension related to Verapamil use. Potassium chloride (Choice C) and Magnesium sulfate (Choice D) are not the appropriate medications to address the hypotension in this situation.

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