Nursing Elites

1. A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?

• A. Increase cardiac output
• B. Reduce fluid retention
• C. Decrease heart rate
• D. Lower blood pressure

Correct answer: C

Rationale: Carvedilol, a beta-blocker, is primarily prescribed in patients with chronic heart failure to decrease heart rate and reduce the workload on the heart. By lowering the heart rate, carvedilol helps the heart function more efficiently and improves symptoms in patients with heart failure.

2. A client with a history of hypertension is prescribed lisinopril (Prinivil). Which side effect should the nurse monitor for?

• A. Dry cough.
• B. Weight gain.
• C. Tachycardia.
• D. Hyperglycemia.

Correct answer: A

Rationale: The correct answer is A: Dry cough. Lisinopril is an ACE inhibitor, and a common side effect of ACE inhibitors is a dry cough. This occurs due to the accumulation of bradykinin in the lungs, leading to irritation and subsequent cough. It is important for the nurse to monitor the client for this side effect as it can affect adherence to the medication regimen. Weight gain, tachycardia, and hyperglycemia are not typically associated with lisinopril. Therefore, choices B, C, and D are incorrect.

3. A 55-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. Imaging shows dilated intrahepatic bile ducts and a normal common bile duct. What is the most likely diagnosis?

• A. Primary biliary cirrhosis
• B. Primary sclerosing cholangitis
• C. Gallstones
• D. Pancreatic cancer

Correct answer: A

Rationale: The presentation of fatigue, pruritus, and jaundice in a 55-year-old woman, along with elevated bilirubin and alkaline phosphatase levels, and imaging findings of dilated intrahepatic bile ducts and a normal common bile duct, are characteristic of primary biliary cirrhosis. Primary biliary cirrhosis is an autoimmune liver disease that typically affects middle-aged women, leading to progressive destruction of the intrahepatic bile ducts.

4. A client with Addison's disease is being treated with fludrocortisone (Florinef). Which electrolyte imbalance should the nurse monitor for?

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

Correct answer: C

Rationale: Fludrocortisone, such as Florinef, is a mineralocorticoid that promotes sodium retention and potassium excretion, which can lead to hypernatremia. Therefore, the nurse should closely monitor for hypernatremia when a client with Addison's disease is being treated with fludrocortisone. Hyperkalemia (Choice A) is incorrect because fludrocortisone promotes potassium excretion, leading to hypokalemia rather than hyperkalemia. Hyponatremia (Choice B) is incorrect as fludrocortisone promotes sodium retention. Hypocalcemia (Choice D) is unrelated to the action of fludrocortisone.

5. A patient with chronic pain is prescribed gabapentin. What is the primary purpose of this medication?

• A. Relieve neuropathic pain
• B. Reduce inflammation
• C. Enhance opioid analgesia
• D. Suppress cough

Correct answer: A

Rationale: Gabapentin is primarily prescribed to relieve neuropathic pain. It works by stabilizing electrical activity in the nerves, making it effective in managing conditions such as diabetic neuropathy, postherpetic neuralgia, and other forms of chronic pain originating from nerve damage.

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