Nursing Elites

1. A healthcare professional working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the healthcare professional's priority?

• A. Administer flumazenil.
• B. Identify the client's level of orientation.
• C. Infuse IV fluids.
• D. Prepare the client for gastric lavage.

Correct answer: B

Rationale: When managing a client with Benzodiazepine toxicity, the priority action for the healthcare professional is to assess the client. Identifying the client's level of orientation allows the healthcare professional to understand the client's cognitive status, which is crucial for further interventions and decision-making in the care plan. Administering flumazenil (Choice A) may precipitate withdrawal symptoms and should be done cautiously. Infusing IV fluids (Choice C) can be important but is not the priority over assessing the client. Gastric lavage (Choice D) is not typically recommended due to the risk of complications and its limited effectiveness in cases of Benzodiazepine overdose.

2. When should a blood sample be obtained for a peak serum level of gentamicin when administered by IV infusion for 1 hour at 0900?

• A. 1000
• B. 1030
• C. 1100
• D. 1130

Correct answer: B

Rationale: The nurse should obtain the blood sample for the peak serum level at 1030. This timing allows for 30 minutes to elapse after the completion of the 1-hour IV infusion, which is the recommended window for obtaining the peak serum level of gentamicin.

3. A client has a prescription for Amphotericin B. Which of the following laboratory values should be monitored by the nurse to assess for an adverse effect of this medication?

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

Correct answer: A

Rationale: Corrected Rationale: Amphotericin B is known to cause nephrotoxicity, a potential adverse effect that can be monitored by checking the client's serum creatinine levels. Regular monitoring of serum creatinine helps in early identification of kidney damage and allows for timely intervention to prevent further complications. Choice B, serum potassium, is not typically associated with adverse effects of Amphotericin B. Choice C, serum sodium, and choice D, serum calcium, are not directly affected by Amphotericin B and are not primary indicators of its adverse effects.

4. A client has a new prescription for Propranolol. Which of the following statements should the nurse include in teaching the client?

• A. You may experience a rapid heart rate while taking this medication.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Increase your intake of high-sodium foods.

Correct answer: C

Rationale: The correct statement to include when teaching a client about Propranolol is to avoid sudden changes in position. Propranolol, a beta-blocker, can lead to dizziness and lightheadedness, particularly when changing positions. Therefore, clients should be advised to change positions slowly to prevent falls and related injuries. Choice A is incorrect because Propranolol actually helps lower heart rate and blood pressure. Choice B is not a specific requirement for taking Propranolol. Choice D is also incorrect as increasing high-sodium foods is not recommended with Propranolol which can affect blood pressure control.

5. A healthcare professional is educating a client about the adverse effects of Metformin. Which of the following adverse effects should the healthcare professional include?

• A. Lactic acidosis.
• B. Hypoglycemia.
• C. Hyperlipidemia.
• D. Weight gain.

Correct answer: A

Rationale: The correct answer is A: Lactic acidosis. Lactic acidosis is a rare but severe side effect of Metformin, particularly in individuals with renal or liver issues. It is crucial for clients taking Metformin to be aware of the symptoms of lactic acidosis, such as muscle pain, weakness, trouble breathing, stomach discomfort, and feeling cold. Choice B, hypoglycemia, is not a common adverse effect of Metformin but can occur when combined with other antidiabetic medications. Choice C, hyperlipidemia, is not a typical adverse effect of Metformin. Choice D, weight gain, is not associated with Metformin use; in fact, Metformin is often associated with weight loss or weight neutrality.

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