Nursing Elites

1. 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 who develop tachycardia, such as in the case of reflex tachycardia induced by Isosorbide Mononitrate, making it the appropriate choice in this scenario. Furosemide (Choice A) is a loop diuretic used for conditions like heart failure and edema, not for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor primarily used for hypertension and heart failure, not for reflex tachycardia. Ranolazine (Choice C) is used for chronic angina but does not specifically address reflex tachycardia.

2. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.

3. A client has a new prescription for Ciprofloxacin. Which of the following instructions should the nurse include?

• A. Take this medication with meals.
• B. Avoid taking this medication with dairy products.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking this medication with dairy products.' Ciprofloxacin should not be taken with dairy products because calcium can interfere with the absorption of the medication. Instructing the client to take it 1 hour before or 2 hours after consuming dairy products will ensure optimal effectiveness of the medication. Choice A is incorrect because Ciprofloxacin is usually recommended to be taken on an empty stomach or with a full glass of water. Choice C is incorrect as there is no specific requirement to take Ciprofloxacin at bedtime. Choice D is also incorrect as there is no need to increase intake of potassium-rich foods in relation to taking Ciprofloxacin.

4. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.

5. A client is receiving imatinib. Which of the following adverse effects should the nurse monitor?

• A. Edema
• B. Constipation
• C. Dry mouth
• D. Urinary retention

Correct answer: A

Rationale: Corrected Rationale: Imatinib is known to cause edema as an adverse effect. The nurse should closely monitor the client for signs of fluid retention, such as swelling of the extremities or weight gain. Edema can indicate potential complications and requires prompt intervention to prevent further issues. Choices B, C, and D are incorrect because they are not typically associated with imatinib use. Constipation, dry mouth, and urinary retention are not commonly reported adverse effects of imatinib therapy.

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