Nursing Elites

1. A client is prescribed furosemide. Which of the following instructions should the nurse include in the teaching?

• A. Take this medication in the morning.
• B. Avoid eating foods high in potassium.
• C. You should take this medication on an empty stomach.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for a client prescribed furosemide is to take the medication in the morning. Furosemide, a diuretic, is best taken in the morning to prevent nocturia, which is excessive urination at night. Taking it earlier in the day can help reduce disruptions to sleep patterns. Therefore, advising the client to take furosemide in the morning is crucial for optimal therapeutic effects. Choices B, C, and D are incorrect because furosemide does not require avoiding potassium-rich foods, does not need to be taken on an empty stomach, and does not mandate limiting fluid intake to 1 liter per day.

2. When starting therapy with Atenolol, which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypertension

Correct answer: C

Rationale: Atenolol, a beta-blocker, can lead to bradycardia as an adverse effect due to its mechanism of action. The nurse should advise the client to monitor their pulse regularly, as a significant decrease may indicate bradycardia, a condition characterized by a slow heart rate.

3. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.

4. A healthcare professional is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the healthcare professional expect to cause an adverse effect when administered concurrently with Fentanyl?

• A. Ampicillin
• B. Diazepam
• C. Furosemide
• D. Prednisone

Correct answer: B

Rationale: Diazepam, a CNS depressant, can lead to severe sedation when administered concurrently with an opioid like Fentanyl due to their additive central nervous system depressant effects. This interaction can potentiate respiratory depression and other CNS effects, increasing the risk of adverse outcomes.

5. A healthcare professional is preparing to administer an IV antibiotic to a client who has a systemic infection. Which of the following actions should the professional take first?

• A. Administer an antihistamine prior to the antibiotic.
• B. Monitor the client's urine output.
• C. Check the client's allergy history.
• D. Assess the client's vital signs.

Correct answer: C

Rationale: The first action the healthcare professional should take is to check the client's allergy history before administering the antibiotic to prevent a potential allergic reaction. It is crucial to identify any known allergies to antibiotics to ensure the client's safety and well-being. Administering an antihistamine prior to the antibiotic (Choice A) is not recommended unless an allergic reaction occurs. Monitoring the client's urine output (Choice B) and assessing the client's vital signs (Choice D) are important but not the first step in this situation. Checking the client's allergy history takes precedence to prevent adverse reactions.

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