Nursing Elites

1. A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

2. A healthcare provider is assessing a client who takes Desmopressin for Diabetes Insipidus. For which of the following adverse effects should the healthcare provider monitor?

• A. Hypovolemia
• B. Hypercalcemia
• C. Agitation
• D. Headache

Correct answer: D

Rationale: The correct answer is D: Headache. Headache during desmopressin therapy can indicate water intoxication, which is a potential adverse effect. Desmopressin is a medication used to treat Diabetes Insipidus by reducing excessive urination and thirst. Monitoring for headaches is crucial as it can signal decreased sodium levels due to water retention, leading to water intoxication, which is a serious concern. Hypovolemia, hypercalcemia, and agitation are not typically associated with desmopressin therapy for Diabetes Insipidus.

3. A client has a new prescription for Hydrochlorothiazide. Which of the following adverse effects should the nurse monitor?

• A. Hyponatremia
• B. Hyperkalemia
• C. Hypercalcemia
• D. Hypoglycemia

Correct answer: A

Rationale: Corrected Rationale: Hydrochlorothiazide, a diuretic, can lead to electrolyte imbalances, particularly hyponatremia (low sodium levels). The nurse should closely monitor the client's sodium levels due to the potential adverse effect of Hydrochlorothiazide. Incorrect Rationales: - Hyperkalemia (Choice B) is less likely to be caused by Hydrochlorothiazide; in fact, it can lead to hypokalemia. - Hypercalcemia (Choice C) is not a common adverse effect of Hydrochlorothiazide. - Hypoglycemia (Choice D) is not directly associated with Hydrochlorothiazide use.

4. A client is receiving discharge instructions for a new prescription of Enoxaparin. Which of the following instructions should the provider include?

• A. Inject the medication into the muscle.
• B. Massage the injection site after administration.
• C. Rotate injection sites between the arms and thighs.
• D. Administer the medication in the abdomen.

Correct answer: D

Rationale: The correct answer is to administer the medication in the abdomen. Enoxaparin is administered as a subcutaneous injection in the abdomen to prevent bleeding complications. Injecting into the muscle or massaging the site can increase the risk of bleeding. Rotating sites between the arms and thighs is not recommended for Enoxaparin administration due to variations in absorption rates. Therefore, the provider should instruct the client to administer Enoxaparin in the abdomen for optimal effectiveness and safety.

5. A client has a new prescription for Timolol. How should the nurse instruct the client to insert eye drops?

• A. Press your finger on the inside corner of your eye for 1 minute after application.
• B. Apply the eye drops directly to the cornea.
• C. Drop the prescribed amount of medication into the center of the conjunctival sac.
• D. Wipe your eyes gently with a tissue immediately after application.

Correct answer: C

Rationale: When administering eye drops, it is essential to instruct the client to drop the prescribed amount of medication into the center of the conjunctival sac. This technique helps ensure proper distribution of the medication and reduces the risk of potential adverse effects. Pressing on the inside corner of the eye is done to prevent systemic absorption, applying drops directly to the cornea can cause irritation, and wiping the eyes after application can lead to decreased effectiveness of the medication.

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