Nursing Elites

1. 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.

2. When taking Digoxin, low levels of what can cause toxicity?

• A. Potassium
• B. Calcium
• C. Sodium
• D. Magnesium

Correct answer: A

Rationale: Low potassium levels can lead to Digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium pump. When potassium levels are low, there is an increased risk of Digoxin binding and toxicity. Choice B (Calcium) is incorrect because low calcium levels are not directly linked to Digoxin toxicity. Choice C (Sodium) is incorrect as low sodium levels do not cause Digoxin toxicity. Choice D (Magnesium) is incorrect as low magnesium levels do not contribute to Digoxin toxicity.

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. Which drug undergoes extensive first-pass hepatic metabolism?

• A. Heparin
• B. Insulin
• C. Propranolol
• D. Nitroglycerin

Correct answer: C

Rationale: Propranolol undergoes extensive first-pass hepatic metabolism in the liver. When administered orally, propranolol is extensively metabolized by the liver before reaching systemic circulation, leading to reduced bioavailability. This process is known as first-pass hepatic metabolism, which significantly affects the drug's effectiveness and necessitates higher oral doses compared to other routes of administration. Heparin (Choice A) is not metabolized by the liver but excreted unchanged by the kidneys. Insulin (Choice B) is a peptide hormone that is not subject to significant first-pass metabolism. Nitroglycerin (Choice D) is primarily metabolized in the blood and tissues, bypassing significant first-pass metabolism in the liver.

5. A nurse is teaching a client who has a new prescription for Prednisone. Which of the following instructions should the nurse include?

• A. Increase your intake of vitamin
• B. Take this medication on an empty stomach.
• C. Avoid drinking grapefruit juice.
• D. Take this medication every other day.

Correct answer: A

Rationale: Prednisone can lead to bone loss, so clients should increase their intake of vitamin D and calcium to help maintain bone health.

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