Nursing Elites

1. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

• A. Take hydrochlorothiazide as needed for edema.
• B. Check your weight once weekly.
• C. Take the hydrochlorothiazide on an empty stomach.
• D. Take the hydrochlorothiazide in the morning.

Correct answer: D

Rationale: The correct answer is to take hydrochlorothiazide in the morning. This medication is usually advised to be taken in the morning to prevent nocturia, which is excessive urination at night. Option A is incorrect because hydrochlorothiazide should be taken daily as prescribed, not as needed for edema. Option B is incorrect as monitoring weight weekly may not be specifically related to hydrochlorothiazide therapy. Option C is incorrect as hydrochlorothiazide does not need to be taken on an empty stomach.

2. A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth)

• A. 0.5 mL
• B. 0.005 mL
• C. 0.05 mL
• D. 5 mL

Correct answer: A

Rationale: To calculate the mL needed, set up a proportion: 5 mg / 1 mL = 2.5 mg / X mL. Cross multiply to find X: 5 * X = 2.5 * 1, X = 2.5 / 5 = 0.5 mL. Therefore, the nurse should administer 0.5 mL. Choice B, 0.005 mL, is incorrect as it doesn't match the calculated result. Choice C, 0.05 mL, is incorrect as it is ten times the correct value. Choice D, 5 mL, is incorrect as it represents the total volume of the entire vial, not the amount needed for the specific dose.

3. When administering subcutaneous epinephrine for a client experiencing anaphylaxis, what adverse effect should the nurse monitor for?

• A. Hypotension
• B. Hyperthermia
• C. Hypoglycemia
• D. Tachycardia

Correct answer: D

Rationale: The correct adverse effect to monitor for when administering subcutaneous epinephrine for anaphylaxis is tachycardia. Epinephrine stimulates adrenergic receptors, leading to an increased heart rate (tachycardia). Hypotension (Choice A) is less likely due to the vasoconstrictive effects of epinephrine. Hyperthermia (Choice B) and hypoglycemia (Choice C) are not commonly associated with epinephrine administration for anaphylaxis.

4. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?

• A. Allergic response
• B. Superinfection
• C. Renal toxicity
• D. Hepatotoxicity

Correct answer: B

Rationale: Candidiasis is a type of superinfection that can occur when antibiotics, like tetracycline, disrupt the normal flora, allowing overgrowth of fungi. Option A, allergic response, is incorrect because candidiasis is not typically an allergic reaction. Option C, renal toxicity, and option D, hepatotoxicity, are incorrect as they refer to adverse effects on the kidneys and liver, respectively, which are not directly related to the development of candidiasis.

5. A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?

• A. If the phenazopyridine upsets my stomach, I can take it with meals.
• B. The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection.
• C. I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin.
• D. I should notify my provider immediately if my urine turns an orange color.

Correct answer: D

Rationale: Phenazopyridine can turn the urine orange, which is a normal side effect and not a cause for alarm. The client's statement about notifying the provider immediately if their urine turns orange indicates a need for further teaching because it shows a misunderstanding of the medication's side effects. Choices A, B, and C demonstrate a good understanding of the prescribed medications and their effects, indicating the client has grasped the teaching provided on those aspects.

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