Nursing Elites

1. When administering medications to a group of clients, which client should the nurse closely monitor for the development of acute kidney injury (AKI)?

• A. Lorazepam
• B. Sucralfate
• C. Digoxin
• D. Vancomycin

Correct answer: D

Rationale: Vancomycin is known to be nephrotoxic, which means it can cause damage to the kidneys. Therefore, clients receiving Vancomycin should be closely monitored for signs and symptoms of acute kidney injury (AKI) to ensure early detection and intervention if necessary. Lorazepam, Sucralfate, and Digoxin do not typically cause acute kidney injury, so they are not the priority for monitoring in this scenario.

2. A 59-year-old client is prescribed furosemide 40 mg twice a day for the management of heart failure. The practical nurse should monitor the client for the development of which complication?

• A. Hypokalemia
• B. Hyperchloremia
• C. Hypercalcemia
• D. Hypophosphatemia

Correct answer: A

Rationale: Corrected Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and chloride in the kidneys, leading to increased potassium excretion and potentially causing hypokalemia. Hypokalemia can lead to cardiac irregularities, making it crucial for the practical nurse to monitor the client for this electrolyte imbalance. Choice B, Hyperchloremia, is not typically associated with furosemide use. Choices C and D, Hypercalcemia and Hypophosphatemia, are not common complications of furosemide therapy.

3. A client with a history of deep vein thrombosis is prescribed edoxaban. The nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: The correct answer is A: Increased risk of bleeding. Edoxaban is an anticoagulant that works by inhibiting clot formation, thereby increasing the risk of bleeding. Therefore, the nurse should closely monitor the client for signs of bleeding, such as bruising, petechiae, hematuria, or gastrointestinal bleeding, to prevent potential complications. Choices B, C, and D are incorrect because edoxaban does not decrease the risk of bleeding or affect the risk of infection; its primary concern is the potential for bleeding due to its anticoagulant properties.

4. Phenazopyridine is commonly prescribed for clients with urinary tract infections (UTI). Which statement by the practical nurse describes the purpose for the administration of phenazopyridine?

• A. To alter the pH level of the urine
• B. To reduce the frequency of bladder spasms
• C. To alleviate the painful symptoms caused by the UTI
• D. To prevent bacterial replication and resistance development

Correct answer: C

Rationale: The correct answer is C. Phenazopyridine, a urinary analgesic, is utilized to alleviate the pain associated with urinary tract infections (UTIs) like burning, pain, urgency, and frequent voiding. The administration of phenazopyridine can cause the urine to turn a bright red-orange color. It is recommended to take this medication with food to reduce gastric irritation. Phenazopyridine should only be used for a maximum of 2 days when taken alongside an antibacterial agent, which is typically prescribed for about 2 weeks to treat the underlying infection.

5. When should a client receiving insulin lispro administer this medication?

• A. Before meals
• B. After meals
• C. At bedtime
• D. Before sleep

Correct answer: A

Rationale: Insulin lispro is a rapid-acting insulin that should be administered shortly before meals. This timing helps to synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing blood glucose levels in the body.

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