Nursing Elites

1. A nurse is teaching a client who has a new prescription for Spironolactone. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, so the nurse should monitor the client for hyperkalemia, which can cause muscle weakness and cardiac dysrhythmias.

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

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

Correct answer: A

Rationale: Corrected Rationale: Hydrochlorothiazide, a diuretic, can lead to electrolyte imbalances, particularly hyponatremia (low sodium levels). The nurse should closely monitor the client's sodium levels due to the potential adverse effect of Hydrochlorothiazide. Incorrect Rationales: - Hyperkalemia (Choice B) is less likely to be caused by Hydrochlorothiazide; in fact, it can lead to hypokalemia. - Hypercalcemia (Choice C) is not a common adverse effect of Hydrochlorothiazide. - Hypoglycemia (Choice D) is not directly associated with Hydrochlorothiazide use.

3. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?

• A. This medication can stain your contacts.
• B. This medication can cause your pupils to constrict.
• C. This medication can absorb into your contacts.
• D. This medication can slow your heart rate.

Correct answer: C

Rationale: The correct instruction the nurse should include is that Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove the contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid any potential absorption of the medication into the lenses. Choices A, B, and D are incorrect because Brimonidine is not known to stain contacts, cause pupil constriction, or slow heart rate.

4. A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

• A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
• B. I will call the provider to get a prescription for discontinuing the IV heparin today.
• C. Both heparin and warfarin work together to dissolve the clots.
• D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.

Correct answer: A

Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.

5. When administering a Serotonin Antagonist, what is important to monitor for?

• A. Intake and output
• B. Mental status changes
• C. Respiratory rate
• D. Anorexia

Correct answer: B

Rationale: When administering a Serotonin Antagonist, monitoring mental status changes is crucial. Serotonin Antagonists can affect neurological function, potentially leading to alterations in mental status. It is essential to assess for any changes in behavior, mood, or cognition to ensure patient safety and prompt intervention if needed.

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