Nursing Elites

1. When a client has a new prescription for Dextromethorphan to suppress a cough, what adverse effect should they monitor for according to the nurse's instruction?

• A. Diarrhea
• B. Anxiety
• C. Sedation
• D. Palpitations

Correct answer: C

Rationale: The correct answer is C: Sedation. Dextromethorphan can lead to sedation as an adverse effect. The nurse should advise the client to avoid activities that require alertness when taking this medication to prevent any potential harm. Monitoring for sedation is crucial to ensure the client's safety and well-being. Choices A, B, and D are incorrect as diarrhea, anxiety, and palpitations are not commonly associated with Dextromethorphan use. While some individuals may experience gastrointestinal upset, central nervous system effects like sedation are more commonly observed.

2. A healthcare provider is reviewing the health history of a client who has a prescription for Propranolol. Which of the following findings should the provider report?

• A. Previous history of thromboembolism
• B. Concurrent use of an antacid
• C. History of bronchial asthma
• D. Recent weight gain

Correct answer: C

Rationale: Propranolol is a nonselective beta-blocker that can cause bronchoconstriction, making it contraindicated for clients with a history of bronchial asthma. Reporting a history of bronchial asthma to the provider is crucial as it would prompt a review of the medication prescription to avoid potential adverse effects and consider alternative treatment options.

3. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.

4. A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should NOT be used with caution in combination with which drug classes?

• A. NSAIDs
• B. Cardiac glycosides
• C. Beta blockers
• D. None of the above

Correct answer: C

Rationale: Calcium channel blockers and beta blockers should be used with caution together because they can both suppress heart function, potentially leading to bradycardia, heart block, or heart failure. NSAIDs and cardiac glycosides do not have significant interactions with calcium channel blockers in the same way, so they are not typically a cause for concern when combined.

5. A client has a new prescription for Valsartan. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypercalcemia

Correct answer: A

Rationale: Corrected Rationale: Valsartan is an angiotensin II receptor blocker (ARB) that can cause hyperkalemia by affecting the renin-angiotensin-aldosterone system. The nurse should closely monitor the client's potassium levels due to the risk of hyperkalemia, which can lead to serious cardiac complications. Choice B, hypoglycemia, is not a common adverse effect of Valsartan. Choice C, bradycardia, is not directly associated with Valsartan use. Choice D, hypercalcemia, is not a typical adverse effect of Valsartan.

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