Nursing Elites

1. A healthcare professional is caring for a client who has a new prescription for Lisinopril. Which of the following laboratory values should the professional monitor?

• A. Serum potassium
• B. Serum sodium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing the excretion of potassium in the kidneys. Monitoring serum potassium levels is essential to prevent complications such as cardiac arrhythmias. Therefore, the healthcare professional should closely monitor the client's serum potassium levels when they are on Lisinopril. Choices B, C, and D are incorrect because Lisinopril primarily affects potassium levels due to its mechanism of action as an ACE inhibitor. Serum sodium, calcium, and magnesium levels are not typically affected by Lisinopril in the same way as potassium.

2. A client is prescribed levothyroxine for hypothyroidism. Which of the following findings should indicate to the nurse that the medication is effective?

• A. Decreased heart rate
• B. Increased energy levels
• C. Weight loss
• D. Improved mental clarity

Correct answer: B

Rationale: Increased energy levels are a key indicator of the effectiveness of levothyroxine in treating hypothyroidism. Levothyroxine works to regulate thyroid hormone levels, which can lead to improved energy levels as the body's metabolism is restored. While the other options may also improve with treatment, increased energy levels directly reflect the correction of the thyroid hormone imbalance. Decreased heart rate can be an indicator of overmedication, weight loss can be attributed to increased metabolism but may not directly reflect the effectiveness of levothyroxine, and improved mental clarity is a more general cognitive improvement that may not directly relate to thyroid function.

3. A child is prescribed Amoxicillin 20 mg/kg/day PO to be administered every 12 hr. The child weighs 44 lb. The available medication is amoxicillin suspension 250 mg/5 mL. How many mL should be given per dose?

• A. 4 mL
• B. 5 mL
• C. 6 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage per administration: Convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the nurse should administer 4 mL of amoxicillin suspension per dose. Choice B, 5 mL, is incorrect because the calculation shows that 4 mL is the correct dose. Choices C and D are also incorrect as they are not in line with the calculated dosage based on the weight of the child and the concentration of the medication.

4. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: An adverse effect of prochlorperazine is acute dystonia, which is evidenced by spasms of the muscles in the face, neck, and tongue. Diphenhydramine is used to suppress extrapyramidal effects of prochlorperazine, making it the most appropriate choice to address the client's spasms. Fomepizole is used in methanol or ethylene glycol poisoning, not for acute dystonia. Naloxone is an opioid antagonist used for opioid overdose, not for acute dystonia. Phytonadione is vitamin K, used for the reversal of warfarin, not for acute dystonia.

5. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

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