Nursing Elites

1. A healthcare professional is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the healthcare professional?

• 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: Performing immediate gastric lavage is the appropriate action for a client with severe lithium toxicity, indicated by a plasma lithium level of 2.1 mEq/L. Gastric lavage can help reduce the client's lithium level by removing the unabsorbed drug from the stomach.

2. Which of the following is not a side effect of the ACE Inhibitor (Captopril)?

• A. Rash
• B. Angioedema
• C. Cough
• D. Congestion

Correct answer: D

Rationale: Congestion is not a common side effect associated with ACE inhibitors such as Captopril. ACE inhibitors are known to cause a dry, persistent cough due to bradykinin accumulation, rash, and angioedema, but congestion is not typically listed as a side effect.

3. What is the classification of Ondansetron?

• A. Antihypertensive
• B. Antiarrhythmic
• C. Antiemetic
• D. Antiulcer agent

Correct answer: C

Rationale: Ondansetron is classified as an antiemetic. It is commonly used to prevent nausea and vomiting, especially in patients undergoing chemotherapy or surgery. Choice A, Antihypertensive, is incorrect as Ondansetron is not used to treat high blood pressure. Choice B, Antiarrhythmic, is incorrect as Ondansetron is not used to manage heart rhythm abnormalities. Choice D, Antiulcer agent, is incorrect as Ondansetron is not primarily indicated for treating ulcers.

4. A healthcare professional in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?

• A. Calcium 9.2 mg/dL
• B. Calcium 10.3 mg/dL
• C. Potassium 3.4 mEq/L
• D. Potassium 4.8 mEq/L

Correct answer: C

Rationale: The correct answer is C: Potassium 3.4 mEq/L. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, especially in older clients taking Digoxin, as potassium plays a crucial role in the heart's electrical activity. Choices A and B are related to calcium levels, which do not directly increase the risk of Digoxin toxicity. Choice D, Potassium 4.8 mEq/L, is within the expected reference range and would not increase the risk of Digoxin toxicity.

5. A nurse is providing discharge instructions to a client who has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a hairy area.
• B. Change the patch every 24 hours.
• C. Avoid exposure to heat sources.
• D. Cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction that the nurse should include when providing discharge instructions for a client with a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, leading to a risk of overdose. Choice A is incorrect because the patch should be applied to a clean, non-hairy area. Choice B is incorrect as the Fentanyl patch is usually changed every 72 hours, not every 24 hours. Choice D is incorrect as the patch should never be cut to adjust the dosage.

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