Nursing Elites

1. The patient is beginning furosemide and has started a 2-week course of a steroid medication. What should the nurse recommend?

• A. Avoid consuming licorice to prevent excess potassium loss.
• B. Report a urine output less than 600 mL/24 hours.
• C. Obtain an order for a potassium supplement.
• D. Take the furosemide in the morning.

Correct answer: C

Rationale: When a patient is taking furosemide and a steroid medication, there is an increased risk of potassium loss due to the interaction between the two drugs. Consuming licorice should be avoided as it can worsen potassium loss. Reporting a urine output less than 600 mL/24 hours is not directly related to the drug interaction and may not be necessary. Taking furosemide at bedtime is not the primary concern when a patient is concurrently on a steroid medication and furosemide. Therefore, obtaining an order for a potassium supplement is the most appropriate recommendation to counteract the potential potassium loss.

2. A patient has been taking spironolactone (Aldactone) to treat heart failure. The nurse will monitor for

• A. hyperkalemia.
• B. hypermagnesemia.
• C. hypocalcemia.
• D. hypoglycemia.

Correct answer: A

Rationale: The correct answer is A: hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in heart failure management. One of the major side effects of spironolactone is hyperkalemia, which is an elevated level of potassium in the blood. Monitoring for hyperkalemia is crucial as it can lead to serious cardiac arrhythmias. Choices B, C, and D are incorrect. Hypermagnesemia (choice B) is not typically associated with spironolactone use. Hypocalcemia (choice C) and hypoglycemia (choice D) are also not directly linked to the use of spironolactone in heart failure treatment.

3. A patient with a diagnosis of Cushing's syndrome is likely to exhibit which of the following symptoms?

• A. Hyperpigmentation.
• B. Moon face.
• C. Hypotension.
• D. Hypertension.

Correct answer: B

Rationale: The correct answer is B: Moon face. Cushing's syndrome is characterized by excess cortisol levels, leading to the distinctive round and full face known as moon face. Hyperpigmentation (choice A) may occur due to increased ACTH levels, but it is not a hallmark symptom like moon face. Hypotension (choice C) is less common in Cushing's syndrome as cortisol typically leads to hypertension (choice D) due to its effects on blood pressure regulation.

4. A client has just been scheduled for endoscopic retrograde cholangiopancreatography (ERCP). What should the nurse tell the client about the procedure? Select all that apply.

• A. That informed consent is required
• B. That the test takes about 1 hour to complete
• C. That premedication for sedation may be necessary
• D. That food and fluids will be withheld before the procedure

Correct answer: B

Rationale: The correct answer is that the ERCP procedure takes about 1 hour to complete. Informed consent is required before the procedure. Premedication for sedation may be necessary as sedation is commonly used during ERCP to keep the client comfortable. Food and fluids are withheld before the procedure to prevent aspiration and ensure a clear view during the procedure. Position changes may be necessary to facilitate the passage of the tube.

5. The healthcare provider is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 mcg/mL to 2.2 mcg/mL. What will the healthcare provider expect the patient to experience?

• A. Inadequate drug effects
• B. Increased risk of superinfection
• C. Minimal adverse effects
• D. Slowed onset of action

Correct answer: A

Rationale: A serum drug trough level below the normal range (1.7 mcg/mL to 2.2 mcg/mL) indicates that the medication concentration is insufficient to provide therapeutic effects, leading to inadequate drug effects. A low trough level does not directly correlate with an increased risk of superinfection, minimal adverse effects, or a slowed onset of action, as these are more related to the drug's concentration within the therapeutic range.

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