Nursing Elites

1. A client with a new prescription for Verapamil to control hypertension is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?

• A. I should avoid drinking grapefruit juice.
• B. I can expect my heart rate to increase while taking this medication.
• C. This medication will cause my urine to turn orange.
• D. I will stop taking this medication if I experience headaches.

Correct answer: A

Rationale: The correct answer is A. Grapefruit juice can increase blood levels of verapamil, leading to increased effects and potentially serious side effects such as hypotension or bradycardia. It is crucial for the client to avoid grapefruit juice while taking Verapamil to prevent these adverse reactions. Choice B is incorrect because verapamil is a calcium channel blocker that typically lowers heart rate. Choice C is incorrect as verapamil does not cause urine discoloration. Choice D is incorrect because stopping medication abruptly without consulting a healthcare provider can be dangerous.

2. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?

• A. Inspect the skin for redness and irritation around the injection site.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to lie down for 30 minutes after oral administration.
• D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.

Correct answer: B

Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.

3. When caring for a client prescribed Digoxin, which of the following laboratory values should the nurse monitor to assess for potential toxicity?

• A. Sodium
• B. Potassium
• C. Magnesium
• D. Calcium

Correct answer: B

Rationale: When a client is prescribed Digoxin, monitoring potassium levels is crucial as hypokalemia can increase the risk of Digoxin toxicity. Low potassium levels can potentiate the effects of Digoxin on the heart, leading to toxicity. Therefore, regular monitoring of potassium levels helps in preventing adverse effects and ensuring the safe use of Digoxin. Sodium, magnesium, and calcium levels are not directly associated with Digoxin toxicity; hence, they are not the primary focus for monitoring in this case.

4. A healthcare provider is providing discharge instructions to a client who is prescribed Prednisone. Which of the following dietary instructions should the healthcare provider include?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: The correct answer is to increase the intake of potassium-rich foods (Choice A). Prednisone can cause potassium depletion, so clients should increase their intake of foods such as bananas, oranges, and spinach. Potassium-rich foods help maintain electrolyte balance and prevent complications associated with low potassium levels, such as muscle weakness and irregular heartbeats. Choices B, C, and D are incorrect because increasing dairy products (Choice B) or avoiding foods high in vitamin K (Choice C) are not specifically related to Prednisone therapy. Decreasing protein intake (Choice D) is also not necessary in this case.

5. A client has been prescribed an ACE Inhibitor for hypertension. Which of the following instructions should be included by the healthcare provider?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Avoid foods high in potassium.
• D. Limit your fluid intake.

Correct answer: A

Rationale: The correct answer is to 'Avoid salt substitutes.' ACE Inhibitors can increase potassium levels, so clients should avoid salt substitutes that contain potassium to prevent hyperkalemia, which is a potential side effect of ACE Inhibitors. Choice B 'Take this medication at bedtime' is incorrect as ACE Inhibitors are usually taken in the morning to avoid nocturnal diuresis. Choice C 'Avoid foods high in potassium' is incorrect because although ACE Inhibitors can increase potassium levels, clients are generally encouraged to consume potassium-rich foods in moderation unless contraindicated. Choice D 'Limit your fluid intake' is also incorrect as ACE Inhibitors do not typically require fluid restrictions unless specified by a healthcare provider for other reasons.

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