Nursing Elites

1. When providing discharge instructions to a client prescribed Prednisone, which of the following dietary instructions should the nurse include?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods. Prednisone can lead to potassium depletion, making it essential to consume foods high in potassium, such as bananas, oranges, and spinach, to maintain electrolyte balance and prevent complications. Choice B is incorrect because increasing dairy products is not specifically necessary when taking Prednisone. Choice C is wrong as foods high in vitamin K are not contraindicated with Prednisone. Choice D is incorrect as there is no need to decrease protein intake when prescribed Prednisone.

2. A patient has been taking hydrocodone, an opioid analgesic for their moderate pain, and they have taken more than the prescribed dose. What should you administer as the antidote if they experience toxicity?

• A. Naloxone
• B. N-acetylcysteine
• C. Atropine
• D. Digoxin immune Fab

Correct answer: A

Rationale: Naloxone is the specific antidote for opioid toxicity. It works by blocking the effects of opioids on the central nervous system, thereby reversing symptoms like respiratory depression and sedation. N-acetylcysteine is used for acetaminophen overdose, while atropine is indicated for certain types of poisonings. Digoxin immune Fab is used for digoxin toxicity. Therefore, in the case of opioid toxicity due to hydrocodone overdose, naloxone is the appropriate antidote.

3. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function and potential worsening heart failure. This finding should be reported promptly to the provider for further evaluation and management to prevent complications. Weight loss, while significant, may be expected with diuretic use. A blood pressure of 104/60 mm Hg is within normal range and can be managed. A potassium level of 3.5 mEq/L is slightly low but not an immediate concern.

4. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)

• A. Thrombocyte count.
• B. Hematocrit.
• C. Amylase.
• D. Liver function tests.

Correct answer: A

Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.

5. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

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