Nursing Elites

1. A client is receiving long-term aspirin therapy. The healthcare provider should monitor the client for which of the following complications?

• A. Hemorrhagic stroke
• B. Thromboembolic stroke
• C. Iron deficiency anemia
• D. Neutropenia

Correct answer: A

Rationale: The correct answer is A: Hemorrhagic stroke. Long-term aspirin therapy can lead to hemorrhagic stroke due to its antiplatelet effects, which increase the risk of bleeding. Aspirin inhibits platelet aggregation, which can predispose the individual to bleeding complications, including hemorrhagic stroke. Choices B, C, and D are incorrect because aspirin therapy is more likely to cause bleeding complications rather than thromboembolic events, iron deficiency anemia, or neutropenia.

2. A client informs the nurse that she has difficulty swallowing tablets and struggles with liquid or chewable medications due to taste. What medication should the nurse request a prescription for when preparing to administer Penicillin V to treat the client's streptococcal infection?

• A. Fosfomycin
• B. Amoxicillin
• C. Nafcillin
• D. Cefaclor

Correct answer: C

Rationale: Nafcillin is an appropriate alternative within the penicillin class for clients who have difficulty swallowing tablets or struggle with liquid or chewable medications. It is available for intramuscular (IM) or intravenous (IV) administration, offering options beyond oral formulations. Fosfomycin, Amoxicillin, and Cefaclor are not suitable alternatives for Penicillin V in this scenario as they belong to different classes of antibiotics and may not be as effective in treating streptococcal infections.

3. A client has a new prescription for Furosemide. What instruction should be included by the nurse during discharge?

• A. Take the medication at bedtime.
• B. Increase intake of foods high in potassium.
• C. Avoid sun exposure.
• D. Limit fluid intake.

Correct answer: B

Rationale: The correct answer is to instruct the client to increase intake of foods high in potassium. Furosemide, a loop diuretic, can lead to potassium depletion. Increasing the intake of foods rich in potassium can help prevent hypokalemia, a potential side effect of Furosemide. Choice A is incorrect as Furosemide is usually recommended to be taken in the morning to avoid disrupting sleep with frequent urination. Choice C is irrelevant to the medication. Choice D is also incorrect as Furosemide is a diuretic and may require increased, not limited, fluid intake to prevent dehydration.

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

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: Corrected Rationale: Enalapril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. The nurse should closely monitor the client for this and instruct them to report it to the healthcare provider if it occurs. Choices B, C, and D are incorrect as weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

5. A healthcare provider is completing a client's medical history. The client takes Simvastatin. The healthcare provider should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in patients with active moderate-to-severe liver disorders, such as active hepatitis C, especially when they are already taking a statin like simvastatin. This combination can increase the risk of liver problems and is not recommended due to the potential for further liver damage. Choices A, B, and D are not directly contraindications for adding Ezetimibe to the client's medications.

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