Nursing Elites

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

• A. Take the medication with food.
• B. Increase your fluid intake.
• C. Avoid consuming dairy products.
• D. Take the medication in the morning.

Correct answer: B

Rationale: Increasing fluid intake is essential when taking allopurinol to prevent the formation of kidney stones. Allopurinol can increase the levels of uric acid in the body, which can lead to kidney stone formation. By increasing fluid intake, the client can help flush out excess uric acid and prevent the development of kidney stones. It is important to drink plenty of water throughout the day to maintain adequate hydration and reduce the risk of kidney stone formation. Choices A, C, and D are incorrect. Taking allopurinol with food or in the morning does not specifically relate to preventing kidney stone formation. Avoiding dairy products is not a standard recommendation when taking allopurinol.

2. The healthcare provider is preparing to assist in the care of a client who has just returned from coronary artery bypass graft (CABG) surgery. Which is the priority action?

• A. Monitor the client's urine output.
• B. Check the client's surgical dressing.
• C. Measure the client's blood pressure.
• D. Assess the client's level of consciousness.

Correct answer: D

Rationale: Assessing the client's level of consciousness is the priority action post-CABG surgery to monitor for signs of cerebral hypoxia or other complications that require immediate intervention. Changes in the client's level of consciousness can indicate neurological deterioration, which is critical to address promptly in this postoperative period. Monitoring urine output, checking surgical dressing, and measuring blood pressure are important aspects of postoperative care but assessing the client's level of consciousness takes precedence as it provides crucial information about the client's neurological status and the need for urgent intervention.

3. The healthcare provider is setting up the bedside unit for a client being admitted to the nursing unit from the emergency department with a diagnosis of coronary artery disease (CAD). The provider should place the highest priority on making sure that which is available at the bedside?

• A. Bedside commode
• B. Rolling shower chair
• C. Oxygen tubing and flowmeter
• D. Twelve-lead electrocardiogram (ECG) machine

Correct answer: C

Rationale: In a client with coronary artery disease (CAD), ensuring the availability of oxygen and a flowmeter at the bedside is crucial. Oxygen is essential for adequate oxygenation, which helps prevent myocardial ischemia, a common complication in CAD. The other options, such as a bedside commode and rolling shower chair, are important for patient comfort and mobility but are not as critical as ensuring proper oxygen supply in a client with CAD. While having an ECG machine available is important for ongoing monitoring, ensuring oxygen availability takes precedence in this scenario.

4. A client with hypertension is prescribed enalapril (Vasotec). The nurse should monitor the client for which adverse effect?

• A. Hypotension
• B. Hypertension
• C. Tachycardia
• D. Hyperglycemia

Correct answer: A

Rationale: Enalapril, an ACE inhibitor, can lead to hypotension, particularly following the initial dose or dosage escalation. This effect is due to the medication's mechanism of action in dilating blood vessels, which can result in lowered blood pressure. Monitoring for hypotension is crucial to prevent complications such as dizziness, lightheadedness, or fainting in clients taking enalapril. Choices B, C, and D are incorrect because enalapril does not typically cause hypertension, tachycardia, or hyperglycemia as adverse effects.

5. A healthcare professional is assessing a client who has a new prescription for levothyroxine. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Increased heart rate
• C. Heat intolerance
• D. Elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a concerning sign of levothyroxine toxicity and should be reported to the provider promptly. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body's thyroid hormones. When a client experiences heat intolerance, it can indicate that the dose of levothyroxine is too high, leading to hyperthyroidism symptoms. Weight gain, increased heart rate, and elevated blood pressure are not typically associated with levothyroxine toxicity; instead, they are more commonly seen in conditions like hypothyroidism.

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