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 nurse is assisting in the care of a client with a history of chronic obstructive pulmonary disease (COPD) who is on oxygen therapy. Which action should the nurse take to ensure the client's safety?

• A. Set the oxygen flow rate to 4 liters per minute.
• B. Remove oxygen while the client is eating.
• C. Ensure the client wears a nasal cannula instead of a face mask.
• D. Maintain the oxygen flow rate at the lowest level that relieves hypoxia.

Correct answer: D

Rationale: For clients with COPD, too much oxygen can suppress their drive to breathe, leading to hypoventilation. Therefore, the nurse should maintain the oxygen flow rate at the lowest level that relieves hypoxia to prevent complications while ensuring adequate oxygenation. Setting the oxygen flow rate too high (Choice A) can be detrimental for the client with COPD. Removing oxygen while the client is eating (Choice B) can compromise oxygenation, which is essential even during meals. While nasal cannulas are commonly used, the choice of oxygen delivery device depends on the client's needs; there may be situations where a face mask (Choice C) is more appropriate.

3. A client with a history of coronary artery disease (CAD) is prescribed atorvastatin (Lipitor). The nurse should teach the client about which common side effect of this medication?

• A. Dry mouth
• B. Muscle pain
• C. Drowsiness
• D. Diarrhea

Correct answer: B

Rationale: Muscle pain is a common side effect of statins like atorvastatin. It is important for the nurse to educate the client about this potential side effect, as it can indicate a serious condition called rhabdomyolysis, which requires immediate medical attention. Dry mouth, drowsiness, and diarrhea are not typically associated with atorvastatin use.

4. A client with chronic obstructive pulmonary disease (COPD) is prescribed theophylline. The nurse should monitor the client for which sign of theophylline toxicity?

• A. Drowsiness
• B. Bradycardia
• C. Nausea
• D. Constipation

Correct answer: C

Rationale: Nausea is an early sign of theophylline toxicity. The nurse should closely monitor the client for this symptom as it can progress to more severe toxicity. Nausea can be a warning sign to prevent further complications and adjust the dosage as necessary. Drowsiness (choice A) is a common side effect of theophylline but not a specific sign of toxicity. Bradycardia (choice B) and constipation (choice D) are not typically associated with theophylline toxicity. Therefore, the correct answer is C.

5. The nurse is preparing to administer an intravenous dose of furosemide (Lasix) to a client with heart failure. The nurse should monitor for which potential side effect?

• A. Hypertension
• B. Hyperkalemia
• C. Hypokalemia
• D. Hypoglycemia

Correct answer: C

Rationale: Furosemide is a loop diuretic that works by promoting the excretion of water and electrolytes, including potassium. This loss of potassium can lead to hypokalemia, which can be a potential side effect of furosemide administration. Hypokalemia can result in cardiac dysrhythmias and other complications, especially in clients with heart failure who may already have compromised cardiac function. Therefore, monitoring for signs of hypokalemia, such as muscle weakness, cardiac irregularities, and fatigue, is essential when administering furosemide. Choice A, hypertension, is incorrect because furosemide is actually used to treat hypertension by reducing excess fluid in the body. Choice B, hyperkalemia, is incorrect as furosemide causes potassium loss, leading to hypokalemia. Choice D, hypoglycemia, is unrelated to the mechanism of action of furosemide and is not a common side effect associated with its administration.

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