Nursing Elites

1. A nurse is preparing to administer furosemide to a client. Which of the following findings indicates the client may be at risk for an adverse effect of the medication?

• A. Hypertension
• B. Hypokalemia
• C. Increased urine output
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia, which is a common adverse effect. Hypokalemia can result in serious complications like cardiac arrhythmias. Choices A, C, and D are not directly associated with the adverse effects of furosemide. Hypertension is a condition that furosemide is often used to treat, increased urine output is an expected effect of furosemide, and hyperglycemia is not a typical adverse effect of this medication.

2. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

• A. Asthma
• B. Hypertension
• C. Tachydysrhythmias
• D. Urolithiasis

Correct answer: A

Rationale: The correct answer is A: Asthma. Clients with asthma should avoid Beta2 Blockade agents like propranolol as they can lead to bronchoconstriction, potentially worsening asthma symptoms. Choice B, hypertension, is not a contraindication for propranolol; in fact, it is commonly prescribed for hypertension. Choice C, tachydysrhythmias, is often an indication for propranolol due to its antiarrhythmic properties. Choice D, urolithiasis, does not directly impact the use of propranolol.

3. A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?

• A. Calcium channel blockers
• B. Potassium-sparing diuretics
• C. Beta blockers
• D. Loop diuretics

Correct answer: D

Rationale: The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.

4. A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?

• A. Osteoporosis
• B. Hypertension
• C. Peptic ulcer disease
• D. Immunosuppression

Correct answer: C

Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.

5. A client is receiving chemotherapy and develops stomatitis. Which of the following interventions should the nurse include in the client's plan of care?

• A. Apply warm compresses to the mouth
• B. Rinse mouth with alcohol-free mouthwash
• C. Increase fluid intake
• D. Clean the mouth gently with a soft toothbrush after meals

Correct answer: A

Rationale: The correct answer is to apply warm compresses to the mouth. Stomatitis is an inflammation of the mucous lining in the mouth and can be a side effect of chemotherapy. Warm compresses can help soothe the affected area and promote healing. Choice B is incorrect because alcohol-based mouthwash can further irritate the mouth. Choice C is also a good intervention as increasing fluid intake can help keep the mouth moist and promote healing. However, the most direct intervention for soothing and healing the affected area is applying warm compresses. Choice D is incorrect because using a firm toothbrush can be too harsh and cause further irritation.

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