Nursing Elites

1. A client has been prescribed furosemide (Lasix), and the nurse is monitoring for adverse effects associated with this medication. Which of the following should the nurse recognize as a potential adverse effect? Select one that doesn't apply.

• A. Nausea
• B. Tinnitus
• C. Hypotension
• D. Hypokalemia

Correct answer: A

Rationale: Furosemide is a loop diuretic that can lead to adverse effects such as tinnitus, hypotension, and hypokalemia. While nausea is a common side effect of many medications, it is not typically associated with furosemide. Therefore, the nurse should recognize nausea as a potential adverse effect that doesn't apply to furosemide.

2. Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is instructed to:

• A. Take the medication at bedtime.
• B. Take the medication in the morning with breakfast.
• C. Lie down for 30 minutes after taking the medication.
• D. Take the medication with a full glass of water after rising in the morning.

Correct answer: D

Rationale: Alendronate (Fosamax) should be taken with a full glass of water after rising in the morning to prevent gastrointestinal side effects and increase absorption. Taking the medication with a full glass of water and in an upright position after waking up helps decrease the risk of esophageal irritation and enhances the drug's effectiveness by ensuring proper absorption in the gastrointestinal tract.

3. Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?

• A. Neuralgia
• B. Insomnia
• C. Use of nitroglycerin
• D. Use of multivitamins

Correct answer: C

Rationale: The correct answer is C. Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide and is contraindicated with the concurrent use of organic nitrates and nitroglycerin. Using nitroglycerin together with Viagra can lead to severe hypotension and cardiovascular collapse, making it unsafe to combine both medications.

4. A client is taking phenytoin (Dilantin) for seizure control, and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range?

• A. 5 to 10 mcg/mL
• B. 10 to 20 mcg/mL
• C. 20 to 30 mcg/mL
• D. 30 to 40 mcg/mL

Correct answer: B

Rationale: The correct therapeutic serum drug level range for phenytoin (Dilantin) is 10 to 20 mcg/mL. This range is considered optimal for seizure control while minimizing the risk of toxicity. Monitoring drug levels helps ensure that the client is within the therapeutic range for effective treatment.

5. The healthcare provider is applying a topical corticosteroid to a client with eczema. The healthcare provider should monitor for the potential of increased systemic absorption of the medication if the medication were being applied to which of the following body areas?

• A. Back
• B. Axilla
• C. Soles of the feet
• D. Palms of the hands

Correct answer: B

Rationale: The axilla has thinner skin, making it more permeable to topical medications. Areas with thinner skin, like the axilla, allow for higher systemic absorption of topical corticosteroids.

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