Nursing Elites

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

• A. Take this medication at bedtime.
• B. Increase your fluid intake.
• C. Avoid foods high in calcium.
• D. Take this medication with meals.

Correct answer: B

Rationale: Allopurinol can cause kidney stones due to the formation of uric acid crystals, so it is crucial for the client to increase their fluid intake. Adequate hydration helps to prevent the formation of kidney stones by diluting the urine and promoting the excretion of uric acid. Therefore, advising the client to increase their fluid intake is essential in preventing this adverse effect while taking Allopurinol.

2. A client has a new prescription for Lisinopril. Which of the following laboratory values should be monitored?

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

Correct answer: A

Rationale: Corrected Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing potassium excretion through the kidneys. Monitoring serum potassium levels is crucial to detect hyperkalemia early and prevent adverse effects such as cardiac arrhythmias. Choices B, C, and D are incorrect because Lisinopril is not known to significantly impact sodium, calcium, or magnesium levels in the same way it affects potassium levels.

3. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify the trough levels of a medication accurately, the nurse should obtain a blood specimen immediately before administering the next dose of the medication. The trough level represents the lowest concentration of the medication in the bloodstream, typically right before the next dose is due. This timing ensures an accurate assessment of the drug's concentration in the body at its lowest point, aiding in determining the drug's effectiveness and potential toxicity levels. Choice B is incorrect because waiting for 24 hours would not provide the trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect as obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level.

4. A client has a prescription for ceftriaxone. Which of the following information should the nurse include in the teaching?

• A. You may develop a cough while taking this medication.
• B. You should stop taking this medication if you develop a rash.
• C. This medication cannot be given orally.
• D. This medication may cause your urine to turn yellow.

Correct answer: B

Rationale: The correct answer is B. A rash can indicate an allergic reaction to ceftriaxone, which should be reported to the provider. It is crucial to instruct the client to discontinue the medication and seek medical attention if a rash develops to prevent potential serious adverse effects. Choices A, C, and D are incorrect because cough is not a common side effect of ceftriaxone, ceftriaxone is typically administered parenterally, and a yellow discoloration of urine is a harmless side effect due to the color of the medication itself, respectively.

5. A client is starting therapy with cisplatin. The healthcare provider should instruct the client to report which of the following adverse effects?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is tinnitus. Cisplatin can cause ototoxicity, which may manifest as tinnitus. Tinnitus should be reported promptly to the healthcare provider to prevent further hearing damage.

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