Nursing Elites

1. A client with chronic kidney disease is being educated by a nurse about managing their condition. Which of the following statements shows an understanding of the teaching?

• A. I will need to take an iron supplement.
• B. I will consume foods high in phosphorus.
• C. I will reduce my intake of carbohydrates.
• D. I will monitor my blood glucose level daily.

Correct answer: A

Rationale: The correct answer is A. Clients with chronic kidney disease often develop anemia due to reduced erythropoietin production, leading to decreased red blood cell production. Iron supplementation is frequently required to enhance red blood cell production. Choices B, C, and D are incorrect because in chronic kidney disease, there is a need to restrict phosphorus intake, control carbohydrate intake for blood sugar management, and monitor electrolytes and fluid balance rather than blood glucose levels.

2. A client is being educated by a nurse about the use of carbidopa-levodopa. Which of the following should be included?

• A. It will cure Parkinson's disease
• B. Monitor for dyskinesia
• C. It can be taken with food
• D. It is an opioid medication

Correct answer: B

Rationale: The correct answer is to 'Monitor for dyskinesia.' Carbidopa-levodopa can cause dyskinesia as a side effect, characterized by involuntary movements. Monitoring for this side effect is crucial. Choice A is incorrect because carbidopa-levodopa helps manage symptoms of Parkinson's disease but does not cure it. Choice C is incorrect because carbidopa-levodopa should be taken on an empty stomach to enhance absorption. Choice D is incorrect because carbidopa-levodopa is not an opioid medication.

3. A nurse is caring for a client receiving radiation treatments for cancer. The client states he is experiencing dryness, redness, and scaling at the treatment area. Which of the following should the nurse instruct the client to do?

• A. Sit in the sun for 15 minutes per day.
• B. Apply moist heat to the area twice daily.
• C. Liberally apply prescribed lotion to the area.
• D. Wash the affected area daily with antimicrobial soap.

Correct answer: C

Rationale: The nurse should instruct the client to liberally apply prescribed lotion to the treatment area. Prescribed hydrating lotions help soothe and protect irradiated skin, reducing dryness, redness, and scaling. Sitting in the sun can further damage the skin. Applying moist heat may exacerbate the skin condition. Washing the area with antimicrobial soap can be too harsh and further irritate the skin.

4. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

• A. Asthma
• B. Hypertension
• C. Tachydysrhythmias
• D. Urolithiasis

Correct answer: A

Rationale: Corrected Rationale: Propranolol, a non-selective beta-blocker, should be avoided in clients with asthma as it can cause bronchoconstriction due to its beta2-blocking effects. Therefore, a client history finding of asthma would require the nurse to clarify this medication prescription. Hypertension, tachydysrhythmias, and urolithiasis are not contraindications for propranolol use, making them incorrect choices. For clients with asthma, a beta1 selective blocker would be preferred to avoid exacerbating bronchoconstriction.

5. A nurse is caring for a client who has a prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Bradycardia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Tinnitus

Correct answer: B

Rationale: The correct answer is B: Hyperkalemia. Enalapril, an ACE inhibitor, can lead to hyperkalemia by reducing aldosterone levels, which results in potassium retention. Bradycardia (Choice A) is not a common adverse effect of enalapril. Hyperglycemia (Choice C) and tinnitus (Choice D) are also not typically associated with enalapril use.

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