Nursing Elites

1. A healthcare professional is caring for a client who is prescribed Metformin. Which of the following laboratory values should the healthcare professional monitor to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin A1c
• D. Serum creatinine

Correct answer: D

Rationale: Corrected Rationale: Metformin can lead to lactic acidosis, especially in individuals with impaired renal function. Monitoring the client's serum creatinine levels is crucial to assess kidney function because Metformin is eliminated by the kidneys, and impaired renal function can increase the risk of adverse effects. Monitoring blood glucose levels is essential for assessing the effectiveness of Metformin in managing diabetes but is not directly related to potential adverse effects of Metformin. Creatine kinase is not typically monitored in relation to Metformin therapy. Hemoglobin A1c is used to assess long-term glucose control in diabetes but is not specific for monitoring Metformin adverse effects.

2. A nurse is providing teaching to a client who has asthma and is beginning to take montelukast. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will use this medication as a rescue inhaler during asthma attacks.
• B. I should take this medication once daily in the evening.
• C. I need to have my blood levels checked regularly while taking this medication.
• D. I should take this medication before exercising to prevent bronchospasm.

Correct answer: B

Rationale: Montelukast is typically taken once daily in the evening for long-term control of asthma symptoms. It helps prevent asthma attacks by reducing inflammation in the airways. While montelukast can also be used for exercise-induced bronchospasm in some cases, it is generally not a rescue medication and should be taken regularly, not on an as-needed basis.

3. A nurse is caring for a client in an outpatient facility who has been taking Acarbose for type 2 Diabetes Mellitus. Which of the following laboratory tests should the nurse plan to monitor?

• A. WBC
• B. Serum potassium
• C. Platelet count
• D. Liver function test

Correct answer: D

Rationale: The correct answer is D, Liver function test. Acarbose can cause liver toxicity when taken long-term. Monitoring liver function tests periodically is essential to assess for any potential liver damage. Choices A, B, and C are incorrect because Acarbose does not directly impact white blood cell count, serum potassium levels, or platelet count.

4. A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?

• A. Four medications decrease the risk of a severe allergic reaction.
• B. Four medications reduce the chance that the bacteria will become resistant.
• C. Four medications reduce the risk of adverse reactions.
• D. Four medications decrease the chance of having a positive tuberculin skin test.

Correct answer: B

Rationale: The correct answer is B. When treating tuberculosis, using a combination of medications is crucial to reduce the risk of bacteria developing resistance to any single drug. This approach helps prevent treatment failure and ensures successful treatment outcomes. Choice A is incorrect because the primary purpose of using multiple medications is not related to allergic reactions. Choice C is incorrect as the risk reduction is mainly focused on bacterial resistance rather than adverse reactions. Choice D is not relevant as the purpose of taking multiple medications is not to affect the tuberculin skin test results.

5. A healthcare professional is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the healthcare professional administer per dose?

• A. 0.8 mL
• B. 0.75 mL
• C. 0.5 mL
• D. 1 mL

Correct answer: A

Rationale: To calculate the volume to administer, use the formula: (Desired dose / Concentration) = Volume to administer. In this case, (15,000 units / 20,000 units/mL) = 0.75 mL, which is rounded up to 0.8 mL. Therefore, the healthcare professional should administer 0.8 mL per dose of heparin. Choice B (0.75 mL) is incorrect as it is the exact calculated volume but needs to be rounded up. Choices C (0.5 mL) and D (1 mL) are incorrect as they do not reflect the correct calculated volume for the desired dose of heparin.

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