Nursing Elites

1. When teaching a client about the use of lisinopril, which of the following instructions should the nurse include?

• A. Monitor your blood pressure regularly.
• B. Take the medication with food.
• C. Increase your intake of potassium-rich foods.
• D. Avoid grapefruit juice.

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor their blood pressure regularly when taking lisinopril. Lisinopril is known to cause hypotension, so monitoring blood pressure is crucial to ensure it stays within a safe range. This monitoring helps in early detection of any potential issues related to low blood pressure, allowing for timely intervention. Choices B, C, and D are incorrect because taking lisinopril with food, increasing potassium-rich foods intake, and avoiding grapefruit juice are not specific instructions related to the safe and effective use of lisinopril.

2. The client is taking interferon alfa-2a (Roferon-A) and ribavirin (Virazole) combination therapy for hepatitis C and reports overwhelming feelings of depression. Which action should the nurse implement first?

• A. Recommend mental health counseling.
• B. Review the medication actions and interactions.
• C. Assess the client's daily activity level.
• D. Provide information about a support group.

Correct answer: B

Rationale: The priority action for the nurse is to review the medication actions and interactions. Interferon alfa-2a and ribavirin combination therapy for hepatitis C can lead to neuropsychiatric side effects, including depression. By assessing the medication actions and interactions, the nurse can identify if the depression is a known side effect of the medications, and further intervention or adjustment of the treatment plan may be required to address the client's emotional well-being. Recommending mental health counseling (choice A) may be necessary but should come after ensuring that the depression is not solely caused by medication side effects. Assessing the client's daily activity level (choice C) and providing information about a support group (choice D) are important interventions but addressing the medication's potential contribution to the depression takes precedence.

3. The client admitted to the hospital with pulmonary edema is preparing for discharge. The client should be reminded of the importance of complying with which measure to prevent a recurrence?

• A. Weigh oneself every morning before breakfast.
• B. Sleep with the head elevated on multiple pillows.
• C. Adjust diuretic dose without healthcare provider guidance.
• D. Take additional digoxin (Lanoxin) as a preventive measure.

Correct answer: A

Rationale: Monitoring weight daily, especially in the morning before breakfast, is crucial in detecting fluid retention early and preventing pulmonary edema. Sudden weight gain can indicate fluid accumulation, prompting timely intervention to prevent complications. Choice A is the correct answer because daily weight monitoring is a key component in managing heart failure and preventing pulmonary edema recurrence. Choices B and D are not directly related to preventing fluid retention or pulmonary edema recurrence. Choice C is unsafe as adjusting diuretic doses without healthcare provider guidance can lead to electrolyte imbalances and worsening of the condition.

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

• A. Take the medication with a full glass of water.
• B. Avoid consuming dairy products.
• C. Take the medication on an empty stomach.
• D. Expect a metallic taste in your mouth.

Correct answer: B

Rationale: The correct instruction for a client prescribed phenytoin is to avoid consuming dairy products. Dairy products can reduce the absorption of phenytoin. Taking the medication with a full glass of water (Choice A) is generally a good practice for oral medications but is not specifically required for phenytoin. Taking the medication on an empty stomach (Choice C) can lead to gastrointestinal upset, so it is not recommended for phenytoin. Expecting a metallic taste in the mouth (Choice D) is a possible side effect of phenytoin but is not a crucial instruction for the client to follow.

5. A nurse is assessing a client who is taking hydrocodone. Which of the following findings should the nurse report to the provider?

• A. Constipation
• B. Sedation
• C. Dry mouth
• D. Respiratory depression

Correct answer: D

Rationale: The correct answer is D: Respiratory depression. Hydrocodone is an opioid medication that can cause respiratory depression, a serious side effect that should be reported immediately to the healthcare provider. Constipation, sedation, and dry mouth are common side effects of hydrocodone but are not as concerning as respiratory depression. Constipation can be managed with lifestyle modifications and medications, sedation may improve with time or dosage adjustments, and dry mouth is a common and usually benign side effect.

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