Nursing Elites

1. 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.

2. When caring for a client prescribed warfarin, which laboratory test should the nurse monitor to evaluate the therapeutic effect of the medication?

• A. aPTT
• B. Platelet count
• C. BUN
• D. PT/INR

Correct answer: D

Rationale: The correct laboratory test to monitor the therapeutic effect of warfarin is the PT/INR. Warfarin affects blood clotting, and the PT/INR levels indicate the effectiveness of the medication in preventing clot formation. Therefore, monitoring PT/INR levels helps ensure that the client is within the therapeutic range and is protected from potential complications related to clotting. Choice A (aPTT) is incorrect because while it measures the clotting time, it is not the preferred test for monitoring warfarin therapy. Choice B (Platelet count) is incorrect as it assesses the number of platelets and not the medication's therapeutic effect. Choice C (BUN) is unrelated to monitoring the effects of warfarin therapy and is primarily used to assess kidney function.

3. A client has a new prescription for Losartan. Which of the following instructions should be included?

• A. Avoid drinking grapefruit juice.
• B. Take this medication with a full glass of water.
• C. Take this medication on an empty stomach.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct instruction for a client prescribed Losartan is to monitor for signs of dehydration. Losartan can lead to dehydration, so it is essential for the client to be vigilant for symptoms such as dry mouth, increased thirst, and decreased urine output. Providing the instruction to monitor for signs of dehydration ensures the client's safety and helps in early identification of any potential issues related to dehydration. Choices A, B, and C are incorrect as Losartan does not interact with grapefruit juice, does not require specific instructions regarding water intake, and does not need to be taken on an empty stomach.

4. A child with Cystic Fibrosis has a new prescription for Acetylcysteine. Which of the following information should the nurse include in the instructions?

• A. Expect this medication to suppress your cough.
• B. Expect this medication to smell like rotten eggs.
• C. Expect this medication to cause euphoria.
• D. Expect this medication to turn your urine orange.

Correct answer: B

Rationale: The correct answer is B: 'Expect this medication to smell like rotten eggs.' Acetylcysteine contains sulfur, which gives it a characteristic rotten-egg odor. This smell is normal and expected when using this medication. Choices A, C, and D are incorrect. Acetylcysteine is not used to suppress cough, cause euphoria, or turn urine orange.

5. A client is starting a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Weigh yourself daily.
• B. Limit sodium intake.
• C. Increase potassium intake.
• D. Avoid potassium-rich foods.

Correct answer: A

Rationale: The correct instruction to include when starting furosemide is to weigh yourself daily. Daily weighing helps monitor for fluid loss or retention, which is crucial when taking a diuretic like furosemide. Choices B, C, and D are incorrect because although monitoring sodium intake and potassium levels are important when taking furosemide, the most immediate and direct way to assess the medication's effectiveness and the body's response is through daily weight monitoring.

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