Nursing Elites

1. A healthcare provider is providing discharge teaching to a client who has a new prescription for furosemide. Which of the following statements should the provider include?

• A. Expect muscle pain.
• B. Monitor your weight daily.
• C. Avoid consuming grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: D

Rationale: When a client is prescribed furosemide, an important consideration is preventing hypokalemia, a potential side effect of the medication. Furosemide can lead to potassium depletion, so increasing the intake of potassium-rich foods is crucial to maintain adequate potassium levels in the body. Choices A, B, and C are incorrect because muscle pain is not a common side effect of furosemide, monitoring weight daily may not be directly related to the medication, and avoiding grapefruit juice is more relevant for certain medications that interact with grapefruit juice, not furosemide.

2. What preoperative instruction should the LPN/LVN reinforce to a client scheduled for a carotid endarterectomy?

• A. You will need to be NPO after midnight before the surgery.
• B. You should avoid deep breathing and coughing after the surgery.
• C. You will be able to eat and drink normally after the procedure.
• D. You can take all of your prescribed medications the morning of surgery.

Correct answer: A

Rationale: The correct preoperative instruction that the LPN/LVN should reinforce to a client scheduled for a carotid endarterectomy is being NPO after midnight before the surgery. This instruction is essential to prevent aspiration and ensure a safe procedure. Avoiding oral intake helps reduce the risk of complications during anesthesia induction and the surgical process. Choices B, C, and D are incorrect because avoiding deep breathing and coughing, resuming normal eating and drinking, and taking all prescribed medications the morning of surgery are not recommended preoperative instructions for a carotid endarterectomy.

3. The client with Raynaud's phenomenon is being taught by the nurse about preventing episodes. Which instruction should the nurse reinforce?

• A. Wear gloves in cold weather.
• B. Avoid caffeine and chocolate.
• C. Increase intake of vitamin C.
• D. Use a heating pad for warmth.

Correct answer: A

Rationale: The correct answer is A: 'Wear gloves in cold weather.' Wearing gloves in cold weather is essential for preventing vasoconstriction and subsequent episodes of Raynaud's phenomenon. Cold temperatures can trigger vasospasms in individuals with Raynaud's, and wearing gloves helps maintain warmth and prevent the constriction of blood vessels in the extremities, reducing the likelihood of an episode. Choices B, C, and D are incorrect because while avoiding caffeine and chocolate, increasing vitamin C intake, and using a heating pad for warmth can be beneficial for overall health, they are not specifically targeted at preventing Raynaud's phenomenon episodes triggered by cold weather.

4. A client has been taking levothyroxine for 6 months. Which of the following findings indicates that the medication is effective?

• A. Weight gain
• B. Increased heart rate
• C. Decreased TSH levels
• D. Elevated blood pressure

Correct answer: C

Rationale: In a client taking levothyroxine for thyroid hormone replacement, decreased TSH levels indicate that the medication is effective. TSH levels decrease as the thyroid hormone levels are adequately replaced by levothyroxine, signaling a positive response to treatment. Choices A, B, and D are incorrect because weight gain, increased heart rate, and elevated blood pressure are not expected findings indicating the effectiveness of levothyroxine therapy. Weight gain may suggest inadequate dosing, while increased heart rate and elevated blood pressure could indicate over-replacement or side effects of the medication.

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

• A. Take the medication with food.
• B. Monitor for signs of hypokalemia.
• C. Take the medication at bedtime.
• D. Monitor for a dry cough.

Correct answer: D

Rationale: The correct answer is to monitor for a dry cough. Captopril is known to cause a persistent dry cough as a common side effect. If a dry cough develops, it should be reported to the healthcare provider promptly, as it may necessitate discontinuation of the medication. Choice A is incorrect because captopril is usually taken on an empty stomach. Choice B is incorrect as hypokalemia is not a common side effect of captopril. Choice C is incorrect as captopril is typically taken during the day and not specifically at bedtime.

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