Nursing Elites

1. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?

• A. Spironolactone
• B. Furosemide
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: A

Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.

2. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients experiencing tachycardia, including those with reflex tachycardia induced by medications like Isosorbide Mononitrate. Furosemide (Choice A) is a diuretic and is not indicated for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor used for hypertension and heart failure, not tachycardia. Ranolazine (Choice C) is used in chronic angina but does not address tachycardia.

3. A client with a history of preterm labor is reviewing a new prescription for Terbutaline. Which of the following client statements indicates understanding of the teaching?

• A. I will increase my daily fluid intake to 3 quarts.
• B. I can increase my activity now that I've started on this medication.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider because these are manifestations of preterm labor. This response demonstrates the client's understanding of the importance of monitoring contractions and seeking appropriate medical attention. Choices A, B, and D are incorrect because increasing fluid intake, increasing activity, or assuming the medication will prevent preterm labor are not relevant actions in managing preterm labor or taking Terbutaline.

4. When educating a client starting Simvastatin, which instruction should the nurse provide?

• A. Take this medication in the evening.
• B. Change positions slowly when rising from a chair.
• C. Maintain a consistent intake of green leafy vegetables.
• D. Limit fluid intake to 1 L per day.

Correct answer: A

Rationale: The correct answer is to take Simvastatin in the evening. This timing is important because the body synthesizes the most cholesterol at night. By taking the medication in the evening, its effectiveness is increased, leading to better outcomes for the client.

5. A client is receiving chemotherapy and has a prescription for ondansetron IV for nausea and vomiting. The nurse should monitor the client for which of the following adverse effects?

• A. Hypotension
• B. Bradycardia
• C. Tremors
• D. Urinary retention

Correct answer: C

Rationale: The correct answer is C: Tremors. Ondansetron can cause tremors as an adverse effect. Monitoring for tremors is essential as it can indicate a potential adverse reaction to the medication. Hypotension (choice A) and bradycardia (choice B) are not commonly associated with ondansetron. Urinary retention (choice D) is also not a typical adverse effect of ondansetron, making choices A, B, and D incorrect in this scenario.

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