Nursing Elites

1. Why is it important to monitor ins and outs in patients using ACE inhibitors?

• A. To assess for renal impairment
• B. To ensure the patient is receiving adequate fluid intake
• C. To assess the patient for potential heart failure
• D. To assess for NSAID use

Correct answer: A

Rationale: It is crucial to monitor ins and outs in patients using ACE inhibitors to assess for renal impairment. ACE inhibitors can affect renal function, potentially leading to renal impairment. Monitoring the patient's fluid balance helps in early recognition of any renal issues and allows for timely interventions to prevent complications.

2. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a different site each day.
• B. Remove the patch at bedtime each day.
• C. Apply the patch over an area with little or no hair.
• D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to remove it each day, usually at bedtime, to prevent tolerance. Keeping the patch on for 24 hours at a time can lead to tolerance development. Applying the patch to a different site each day is not necessary, as long as the area is rotated to prevent skin irritation. Applying the patch over an area with little or no hair is not a critical instruction for the Nitroglycerin patch.

3. A patient states he experiences anxiety and has panic attacks at least once a week. What might be helpful for this patient?

• A. Phenytoin (Dilantin)
• B. Lithium
• C. Alprazolam (Xanax)
• D. Spironolactone

Correct answer: C

Rationale: Alprazolam (Xanax) is a medication commonly prescribed to treat anxiety disorders and panic attacks. It belongs to the class of medications known as benzodiazepines, which work by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain to produce a calming effect. Phenytoin is an antiepileptic drug, not typically used for anxiety or panic attacks. Lithium is primarily used to treat bipolar disorder, not anxiety. Spironolactone is a diuretic primarily used to treat conditions like high blood pressure and heart failure, not anxiety or panic attacks.

4. A client has a new prescription for Furosemide. Which of the following instructions should be included?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and falls. Instructing the client to change positions slowly helps prevent these adverse effects by allowing the body to adjust to postural changes gradually, reducing the risk of significant blood pressure drops upon standing up quickly.

5. A client has been prescribed an anticoagulant for atrial fibrillation. Which of the following instructions should the nurse include?

• A. Take the medication with food to prevent nausea.
• B. Avoid activities that may cause injury.
• C. Monitor your heart rate daily before taking the medication.
• D. Avoid alcohol while taking this medication.

Correct answer: B

Rationale: The correct instruction for a client prescribed an anticoagulant for atrial fibrillation is to avoid activities that may cause injury. Anticoagulants increase the risk of bleeding, so it is important to prevent situations that could lead to injury or trauma. Choice A is incorrect because anticoagulants are not typically affected by food intake. Choice C is not necessary for all anticoagulant medications, and heart rate monitoring is more relevant for other conditions. Choice D is not directly related to the action of anticoagulants and is not a priority instruction for this medication.

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