Nursing Elites

1. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.

2. A client has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take this medication in the morning.
• B. Consume potassium-rich foods.
• C. Take this medication with food.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct answer is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and dehydration. The client should be educated to watch for symptoms like dry mouth, increased thirst, weakness, dizziness, and decreased urine output. Prompt recognition of dehydration signs is crucial for timely intervention and prevention of complications. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide in the morning is not a specific instruction for this medication. While potassium-rich foods can be important when taking certain medications, it is not the priority instruction for Hydrochlorothiazide. Taking this medication with food may help reduce stomach upset but is not the most critical instruction for a diuretic like Hydrochlorothiazide.

3. A client is being educated about Fluticasone for treating Perennial Rhinitis. Which statement by the client indicates an understanding of the teaching?

• A. I should use the spray every 4 hours while I am awake.
• B. It can take as long as 3 weeks before the medication takes maximum effect.
• C. This medication can also be used to treat motion sickness.
• D. I can use this medication when my nasal passages are blocked.

Correct answer: B

Rationale: Correct! While the client may experience some benefits of Fluticasone within a few hours, the maximum effects may not be seen until up to 3 weeks of consistent use. This understanding is important to manage expectations and ensure the client uses the medication effectively for the treatment of Perennial Rhinitis.

4. When starting therapy with Lisinopril, a client should be instructed to monitor for which of the following adverse effects?

• A. Tinnitus
• B. Diarrhea
• C. Cough
• D. Weight gain

Correct answer: C

Rationale: When starting therapy with Lisinopril, a client should be instructed to monitor for a persistent dry cough as an adverse effect. Lisinopril, an ACE inhibitor, commonly causes this cough as an adverse effect. It is important for the client to monitor for this symptom and notify their healthcare provider if it occurs. Choices A, B, and D are incorrect because tinnitus, diarrhea, and weight gain are not commonly associated adverse effects of Lisinopril.

5. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

• A. 2+ deep tendon reflexes
• B. 2+ pedal edema
• C. 24 mL/hr urinary output
• D. Respirations 12/min

Correct answer: C

Rationale: In a client receiving Magnesium Sulfate IV for Preeclampsia, a urinary output less than 25 to 30 mL/hr indicates magnesium sulfate toxicity and should be reported to the provider for further evaluation and management. Choice A, 2+ deep tendon reflexes, is a normal finding with magnesium sulfate therapy. Choice B, 2+ pedal edema, is expected in clients with preeclampsia but does not indicate magnesium sulfate toxicity. Choice D, respirations 12/min, is within the normal range and not a concerning finding related to magnesium sulfate administration.

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