Nursing Elites

1. A client is being discharged with a new prescription for furosemide 40 mg PO daily. Which of the following instructions should be included?

• A. Avoid foods rich in potassium.
• B. Take the medication with food.
• C. Weigh yourself daily.
• D. Stand up slowly to minimize orthostatic hypotension.

Correct answer: D

Rationale: The correct answer is D: 'Stand up slowly to minimize orthostatic hypotension.' Clients prescribed furosemide are at risk for orthostatic hypotension, a sudden drop in blood pressure when changing positions. Advising the client to stand up slowly can help prevent this complication. Instructing the client to avoid rapid position changes decreases the likelihood of dizziness or fainting episodes. Choices A, B, and C are incorrect because furosemide does not require avoiding potassium-rich foods, taking the medication with food, or daily weighing as specific instructions.

2. When administering IV Acyclovir to a client with Varicella, what action should the nurse take?

• A. Administer a stool softener
• B. Decrease fluid intake following infusion
• C. Infuse Acyclovir over 1 hr
• D. Monitor for hypotension

Correct answer: C

Rationale: When administering IV Acyclovir to a client with Varicella, the nurse should infuse the medication over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects such as renal damage. Therefore, it is crucial to follow the recommended infusion rate to ensure the client's safety and well-being. Choice A is incorrect as stool softeners are not indicated in this situation. Choice B is incorrect because fluid intake should be maintained or increased to prevent dehydration and support kidney function. Choice D is incorrect as monitoring for hypotension is not specifically related to the administration of IV Acyclovir in Varicella.

3. A client has a new prescription for Furosemide to treat heart failure. Which of the following laboratory results should the nurse monitor?

• A. Potassium level
• B. Sodium level
• C. Hemoglobin A1C
• D. BUN

Correct answer: A

Rationale: The nurse should monitor the client's potassium levels when taking Furosemide because the medication can lead to hypokalemia. Hypokalemia is a potential side effect of Furosemide, a loop diuretic, due to increased potassium excretion in the urine. Monitoring potassium levels is crucial to prevent complications such as cardiac dysrhythmias associated with low potassium levels. Therefore, choices B (Sodium level), C (Hemoglobin A1C), and D (BUN) are incorrect as they are not directly influenced by Furosemide therapy for heart failure.

4. A client who takes Chlorpromazine for the treatment of Schizophrenia is due for a follow-up assessment. The nurse should expect the greatest improvement in which of the following manifestations? (Select all that apply.)

• A. Disorganized speech.
• B. Bizarre behavior.
• C. Impaired social interactions.
• D. Hallucinations.

Correct answer: A

Rationale: When a client takes a conventional antipsychotic medication like chlorpromazine, the greatest improvement is typically seen in positive symptoms such as disorganized speech. These medications are more effective in managing positive symptoms like disorganized speech rather than negative symptoms like impaired social interactions or hallucinations. Therefore, the nurse should anticipate improvement in disorganized speech as a positive response to chlorpromazine treatment.

5. A client is receiving Cefotaxime IV for a severe infection. Which finding indicates a potentially serious adverse reaction to this medication that the nurse should report to the provider?

• A. Diaphoresis
• B. Epistaxis
• C. Diarrhea
• D. Alopecia

Correct answer: C

Rationale: Diarrhea is an adverse effect of cefotaxime and other cephalosporins that requires reporting to the provider. Severe diarrhea might indicate the client has developed antibiotic-associated pseudomembranous colitis, which could be life-threatening. Diaphoresis, epistaxis, and alopecia are not typically associated with cefotaxime use and are less likely to indicate a serious adverse reaction necessitating immediate reporting.

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