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. A client is taking levothyroxine for hypothyroidism. Which of the following findings should indicate to the healthcare provider that the client is experiencing levothyroxine toxicity?

• A. Weight loss
• B. Insomnia
• C. Heat intolerance
• D. Dry skin

Correct answer: C

Rationale: Heat intolerance is a hallmark sign of levothyroxine toxicity. It indicates that the client may be receiving an excessive dose of levothyroxine, leading to hyperthyroid symptoms. This can happen when the dosage is too high, causing the body to have an excess of thyroid hormone. Weight loss is a common symptom of hyperthyroidism but alone does not specifically indicate levothyroxine toxicity. Insomnia can be related to hyperthyroidism but is not a specific sign of levothyroxine toxicity. Dry skin is more commonly associated with hypothyroidism rather than levothyroxine toxicity.

3. The client with a history of heart failure is receiving digoxin (Lanoxin). Which electrolyte imbalance increases the risk of digoxin toxicity?

• A. Hypernatremia
• B. Hypercalcemia
• C. Hypokalemia
• D. Hypomagnesemia

Correct answer: C

Rationale: Hypokalemia increases the risk of digoxin toxicity as low potassium levels enhance the effects of digoxin on the heart, leading to toxicity and potential adverse effects. Hypernatremia (Choice A) is not directly associated with an increased risk of digoxin toxicity. Hypercalcemia (Choice B) does not increase the risk of digoxin toxicity. Hypomagnesemia (Choice D) can contribute to digoxin toxicity, but hypokalemia has a more significant impact on increasing the risk.

4. A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). Which statement indicates an initial understanding of lifestyle alterations?

• A. I should take daily medication for life.
• B. I should eat a diet that is low in fat and cholesterol.
• C. I should continue to smoke to keep the metabolic rate high.
• D. I should begin to exercise if the diet is not sufficient to achieve weight loss.

Correct answer: B

Rationale: Choosing a diet that is low in fat and cholesterol is crucial for managing and preventing the progression of coronary artery disease (CAD). This dietary change can help reduce the risk of further complications associated with CAD, such as plaque buildup in the arteries. It is a fundamental lifestyle alteration that can positively impact the client's heart health. Option A is incorrect as relying solely on medication without lifestyle changes may not address the root cause of CAD. Option C is incorrect as smoking is harmful and worsens CAD. Option D is incorrect because exercise is a crucial part of a healthy lifestyle, but dietary changes should come first in managing CAD.

5. An 81-year-old male client has emphysema. He lives at home with his cat and manages self-care with no difficulty. When making a home visit, the nurse notices that this client's tongue is somewhat cracked, and his eyeballs appear sunken into his head. Which nursing intervention is indicated?

• A. Help the client determine ways to increase his fluid intake.
• B. Obtain an appointment for the client to have an eye examination.
• C. Instruct the client to use oxygen at night and increase humidification.
• D. Schedule the client for tests to determine his sensitivity to cat hair.

Correct answer: A

Rationale: The client's cracked tongue and sunken eyes indicate dehydration. Therefore, the priority nursing intervention is to help the client determine ways to increase his fluid intake. Dehydration can exacerbate the client's emphysema symptoms and lead to further complications. Monitoring and addressing the client's fluid intake is crucial for maintaining his health and well-being. Options B, C, and D are not the immediate priorities in this situation. While an eye examination, oxygen use, and sensitivity tests are relevant aspects of care, addressing dehydration through increased fluid intake takes precedence in this scenario.

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