Nursing Elites

1. A client has a new prescription for Allopurinol. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication at bedtime.
• B. Increase your fluid intake.
• C. Avoid foods high in calcium.
• D. Take this medication with meals.

Correct answer: B

Rationale: Allopurinol can increase the risk of kidney stones as a side effect. To prevent this adverse effect, it is essential for the client to increase their fluid intake. Adequate hydration can help in preventing the formation of kidney stones by keeping urine dilute and flushing out substances that can lead to stone formation.

2. How do ACE inhibitors work?

• A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
• B. Block stimulation of beta 1 and beta 2 at the receptor sites
• C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
• D. None of the above

Correct answer: C

Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.

3. A healthcare professional is providing discharge instructions to a client who has a new prescription for Furosemide. Which of the following instructions should the healthcare professional include?

• A. Take the medication with breakfast.
• B. Increase intake of foods high in potassium.
• C. Avoid prolonged sun exposure.
• D. Limit sodium intake.

Correct answer: B

Rationale: The correct answer is B: 'Increase intake of foods high in potassium.' Furosemide, a loop diuretic, can cause potassium depletion. The healthcare professional should instruct the client to increase the intake of foods high in potassium to prevent hypokalemia, a potential side effect of Furosemide therapy. Choice A is incorrect as Furosemide is usually recommended to be taken in the morning to prevent nocturia. Choice C is unrelated to the side effects of Furosemide. Choice D, while important for overall health, is not directly related to the side effects of Furosemide.

4. A client is taking Epoetin Alfa for anemia. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. White blood cell count
• B. Platelet count
• C. Hematocrit
• D. Serum potassium level

Correct answer: C

Rationale: The nurse should monitor the hematocrit level to evaluate the effectiveness of Epoetin Alfa therapy since it stimulates red blood cell production. Hematocrit reflects the volume of red blood cells in the blood, providing a direct measure of the therapy's impact on increasing red blood cell mass and addressing anemia. Monitoring white blood cell count and platelet count is not directly related to assessing the effectiveness of Epoetin Alfa therapy for anemia. Serum potassium level monitoring may be necessary due to potential side effects of the medication, but it is not the primary indicator of therapy effectiveness in treating anemia.

5. Why is it important to monitor ins and outs in patients using ACE inhibitors?

• A. To assess for renal impairment
• B. To ensure the patient is receiving adequate fluid intake
• C. To assess the patient for potential heart failure
• D. To assess for NSAID use

Correct answer: A

Rationale: It is crucial to monitor ins and outs in patients using ACE inhibitors to assess for renal impairment. ACE inhibitors can affect renal function, potentially leading to renal impairment. Monitoring the patient's fluid balance helps in early recognition of any renal issues and allows for timely interventions to prevent complications.

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