Nursing Elites

1. When teaching a client with a new prescription for spironolactone, which instruction should the nurse include?

• A. Increase your intake of potassium-rich foods.
• B. Avoid consuming grapefruit juice.
• C. Take the medication with food.
• D. Monitor for signs of hyperkalemia.

Correct answer: D

Rationale: The correct answer is to instruct the client to monitor for signs of hyperkalemia when taking spironolactone since it is a potassium-sparing diuretic. Hyperkalemia is a potential adverse effect due to the medication's mechanism of action. Advising the client to increase potassium-rich foods (Choice A) would be incorrect as it can further elevate potassium levels, which could lead to hyperkalemia. Avoiding grapefruit juice (Choice B) is not directly related to spironolactone use. Though taking the medication with food (Choice C) can help reduce gastrointestinal upset, it is not the most critical instruction when initiating spironolactone therapy.

2. A client receives discharge teaching for a new prescription of lithium. Which instruction should be included?

• A. Take the medication with food.
• B. Increase your intake of sodium.
• C. Monitor for signs of hypercalcemia.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct instruction to include when a client receives discharge teaching for a new prescription of lithium is to increase their intake of sodium. Lithium can lead to decreased sodium levels, putting the individual at risk of developing hyponatremia. By increasing sodium intake, the client can counteract this risk, maintain a proper sodium balance, and prevent complications. Choices A, C, and D are incorrect because taking lithium with food, monitoring for signs of hypercalcemia, and avoiding dairy products are not directly related to managing the side effects or risks associated with lithium therapy.

3. A healthcare professional is assessing a client who has a new prescription for warfarin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Frequent urination
• C. Hypokalemia
• D. Bleeding gums

Correct answer: D

Rationale: Bleeding gums are a sign of excessive anticoagulation with warfarin, indicating a potential risk of bleeding complications. It is crucial to report this finding promptly to the provider for further assessment and adjustment of the medication regimen to prevent serious bleeding events. Weight gain, frequent urination, and hypokalemia are not typically associated with warfarin use and are not immediate concerns that require urgent reporting to the provider.

4. The nurse is assisting with the care of a client diagnosed with heart failure. Which finding should the nurse report to the healthcare provider immediately?

• A. Weight gain of 2 pounds in 2 days
• B. Increased urination at night
• C. Mild shortness of breath on exertion
• D. Decreased appetite and fatigue

Correct answer: A

Rationale: A weight gain of 2 pounds in 2 days is concerning in a client with heart failure as it can indicate fluid retention and worsening of the condition. This finding requires immediate medical attention to prevent further complications. Increased urination at night (choice B) may be due to various reasons like diuretic use and is not an immediate concern. Mild shortness of breath on exertion (choice C) is expected in clients with heart failure and may not require immediate reporting. Decreased appetite and fatigue (choice D) are common symptoms in heart failure but are not as urgent as sudden weight gain.

5. A healthcare professional is assessing a client who is taking levodopa/carbidopa. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Urinary retention
• C. Bradykinesia
• D. Dry mouth

Correct answer: C

Rationale: Corrected Rationale: Bradykinesia is a cardinal symptom of Parkinson's disease characterized by slowness of movement. An increase in bradykinesia may indicate a worsening of the disease and the need for adjustments in medication or other interventions. Therefore, it is crucial for the healthcare professional to report this finding to the provider promptly for further evaluation and management. Weight gain, urinary retention, and dry mouth are not directly associated with levodopa/carbidopa therapy or indicative of a worsening condition in Parkinson's disease, making them less urgent findings to report to the provider.

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