Nursing Elites

1. A client has a new prescription for spironolactone. The client should be monitored for which of the following adverse effects?

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

Correct answer: A

Rationale: Corrected Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia as an adverse effect. Hyperkalemia is characterized by elevated levels of potassium in the blood, which can be dangerous and lead to cardiac arrhythmias. Therefore, monitoring for signs and symptoms of hyperkalemia is crucial when a client is taking spironolactone. Choices B, C, and D are incorrect because spironolactone is not known to cause hyponatremia, hypokalemia, or hypercalcemia as adverse effects.

2. A client with Angina Pectoris asks the nurse about the next step if one tablet does not relieve Anginal pain after waiting 5 minutes. Which of the following responses should the nurse make?

• A. Take two more sublingual tablets simultaneously.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes before taking a second sublingual tablet.

Correct answer: B

Rationale: In a situation where Anginal pain persists after taking one sublingual tablet and waiting 5 minutes, it is crucial to call emergency services (911) immediately. This could indicate a myocardial infarction (heart attack) rather than a typical Anginal attack. The client should not take two more sublingual tablets simultaneously without seeking immediate medical help as this could delay appropriate intervention if the pain is due to a heart attack. Taking a sustained-release nitroglycerin capsule is not recommended for immediate relief of acute Anginal pain as it works too slowly. Waiting another 5 minutes before taking a second sublingual tablet is not appropriate if the pain persists, as prompt action is essential in suspected heart-related issues.

3. A female client with tobacco use disorder is being educated by a nurse about Nicotine replacement therapy. Which of the following statements by the client shows understanding of the teaching?

• A. I should avoid eating right before I chew a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking if I become pregnant.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. The client should avoid eating or drinking 15 minutes prior to and while chewing the nicotine gum. Choice B is incorrect because there is no specified timeline for stopping nicotine gum use. Choice C is incorrect because nicotine gum is not recommended during pregnancy. Choice D is incorrect as the client should chew the nicotine gum slowly for about 30 minutes, not quickly for 15 minutes.

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

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

Correct answer: B

Rationale: Nifedipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should monitor the client for swelling in the lower extremities, as it indicates the onset of edema. Hypertension is typically treated with Nifedipine and is not an adverse effect of the medication. Hyperglycemia and bradycardia are not commonly associated with Nifedipine use. Therefore, the correct adverse effect to monitor for when a client is prescribed Nifedipine is edema.

5. When a client is receiving treatment with methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Vitamin D
• C. Calcium
• D. Iron

Correct answer: A

Rationale: Folic acid supplementation is crucial for clients undergoing methotrexate treatment because methotrexate functions as a folic acid antagonist. By supplementing with folic acid, the risk of methotrexate toxicity can be minimized, improving the treatment's effectiveness and safety. Vitamin D, calcium, and iron are not specifically recommended in conjunction with methotrexate therapy and may not provide the same protective benefits as folic acid.

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