Nursing Elites

1. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.

2. A client has a prescription for Trimethoprim-Sulfamethoxazole. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Increase fluid intake.
• C. Expect reddish-orange urine.
• D. Avoid high-protein foods.

Correct answer: B

Rationale: The correct instruction for a client prescribed Trimethoprim-Sulfamethoxazole is to increase fluid intake. This helps prevent crystalluria and kidney stones, which are potential adverse effects of this medication. Adequate hydration is essential to reduce the risk of these complications.

3. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

• A. 2+ deep tendon reflexes
• B. 2+ pedal edema
• C. 24 mL/hr urinary output
• D. Respirations 12/min

Correct answer: C

Rationale: In a client receiving Magnesium Sulfate IV continuous infusion for Preeclampsia, a urinary output less than 25 to 30 mL/hr is indicative of magnesium sulfate toxicity and should be promptly reported to the provider for further evaluation and management. Therefore, the correct answer is C. Option A, 2+ deep tendon reflexes, are expected findings in a client receiving magnesium sulfate and do not require immediate reporting. Option B, 2+ pedal edema, is a common symptom of preeclampsia and typically does not require immediate intervention. Option D, respirations 12/min, are within the normal range and do not indicate an immediate need for reporting to the provider.

4. A healthcare provider is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The provider should recognize which of the following conditions is a contraindication for taking propranolol?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Asthma. Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, making it contraindicated in clients with asthma. Using propranolol in asthma can exacerbate bronchoconstriction and potentially lead to respiratory distress or exacerbation of asthma symptoms. Choices B, C, and D are incorrect. Glaucoma, hypertension, and tachycardia are not contraindications for taking propranolol. In fact, propranolol is commonly used to treat hypertension and tachycardia.

5. A client received IV Verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98/min, and blood pressure is 74/44 mm Hg. The nurse should anticipate a prescription for which of the following IV medications?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Magnesium sulfate

Correct answer: A

Rationale: In this situation, where the client's blood pressure is significantly lowered due to Verapamil administration, the nurse should anticipate a prescription for Calcium gluconate. Calcium gluconate is used to reverse severe hypotension caused by Verapamil. It should be given slowly intravenously as it counteracts the vasodilation caused by Verapamil, helping to normalize blood pressure levels. Sodium bicarbonate is not indicated for low blood pressure. Potassium chloride and magnesium sulfate are not the appropriate choices to address hypotension caused by Verapamil.

Similar Questions