Nursing Elites

1. A patient is receiving spironolactone for heart failure. Which of the following findings should the nurse report to the provider?

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

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia due to its mechanism of action. Hyperkalemia, or elevated potassium levels, can result in serious cardiac complications and requires immediate medical attention. Therefore, the nurse should promptly report any signs or symptoms of hyperkalemia to prevent potential adverse outcomes in the patient. Choices B, C, and D are incorrect because spironolactone is not associated with hypernatremia, hyponatremia, or hypokalemia. Hyperkalemia is the critical finding that the nurse should report in a patient receiving spironolactone.

2. When providing discharge instructions to a client with a new prescription for Levofloxacin, which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid taking this medication with dairy products.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking Levofloxacin with dairy products. This is because calcium in dairy products can interfere with the absorption of the medication. Patients should be advised to take Levofloxacin either 1 hour before or 2 hours after consuming dairy products to ensure optimal effectiveness. Choice A is incorrect because Levofloxacin can be taken with or without food. Choice C is incorrect as the timing of Levofloxacin administration is not specified as at bedtime. Choice D is also incorrect as there is no need to increase intake of potassium-rich foods specifically for Levofloxacin administration.

3. A healthcare professional is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare professional to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: Obtaining help from another healthcare professional to confirm the correct client and blood product is crucial in preventing an acute hemolytic reaction during a blood transfusion. This reaction occurs due to ABO or Rh incompatibility. Verifying the correct client and blood product reduces the risk of administering the wrong blood type, which could lead to a life-threatening reaction. Checking for patency of the IV line (Choice A) is important but does not directly prevent an acute hemolytic reaction. Monitoring vital signs (Choice C) is essential for detecting transfusion reactions but does not prevent them. Staying with the client (Choice D) is important for early recognition of adverse reactions but does not address the root cause of preventing an acute hemolytic reaction.

4. A client receiving chemotherapy reports nausea and vomiting. Which of the following medications should the nurse anticipate administering?

• A. Ondansetron
• B. Metoclopramide
• C. Promethazine
• D. Lorazepam

Correct answer: A

Rationale: The correct answer is A: Ondansetron. Ondansetron is a commonly used antiemetic for managing nausea and vomiting in clients undergoing chemotherapy. It works by blocking serotonin to reduce these symptoms effectively. Metoclopramide (choice B) is another antiemetic but is more commonly used for gastric motility disorders. Promethazine (choice C) is an antihistamine with antiemetic properties, but ondansetron is often preferred for chemotherapy-induced nausea and vomiting due to its efficacy and fewer side effects. Lorazepam (choice D) is a benzodiazepine used for anxiety and insomnia, not typically for managing nausea and vomiting in this context.

5. A client is receiving discharge teaching for Metronidazole prescribed for an infection. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid drinking alcohol while taking this medication.
• B. I should take this medication with food.
• C. I should increase my intake of dairy products while taking this medication.
• D. I should avoid taking dairy products while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Alcohol should be avoided while taking Metronidazole because it can lead to a disulfiram-like reaction, causing severe nausea and vomiting. It is important for the client to understand this to prevent adverse reactions and ensure the effectiveness of the medication in treating the infection. Choices B, C, and D are incorrect because taking Metronidazole with food is recommended to decrease gastrointestinal upset, and there is no specific need to increase or avoid dairy products while taking this medication.

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