Nursing Elites

1. When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?

• A. Serum hepatic enzymes
• B. Fingerstick glucose
• C. Stool color and character
• D. Serum electrolytes and ammonia

Correct answer: D

Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition. Options A, B, and C are incorrect because serum hepatic enzymes, fingerstick glucose, and stool color/character are not directly related to monitoring the response to lactulose therapy in hepatic encephalopathy.

2. A client with diabetes mellitus type 2 is prescribed pioglitazone. What instruction should the nurse include in the client's teaching plan?

• A. Report any signs of heart failure.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of bladder cancer.

Correct answer: A

Rationale: The correct answer is to instruct the client to report any signs of heart failure when taking pioglitazone. Pioglitazone is known to potentially exacerbate heart failure, so it is crucial for clients to monitor and report any symptoms of heart failure promptly to their healthcare provider for appropriate management. Choices B and C are important but not specific to pioglitazone use. Choice D is incorrect as bladder cancer is not a known side effect of pioglitazone.

3. A client with a diagnosis of schizophrenia is prescribed ziprasidone. The nurse should monitor the client for which potential side effect?

• A. QT prolongation
• B. Weight gain
• C. Dry mouth
• D. Increased appetite

Correct answer: A

Rationale: The correct answer is A: QT prolongation. Ziprasidone is known to cause QT prolongation, which can potentially lead to serious cardiac issues. Monitoring the client's ECG is crucial to detect any changes and prevent adverse effects related to QT interval prolongation. Choices B, C, and D are incorrect because weight gain, dry mouth, and increased appetite are not commonly associated with ziprasidone. While weight gain can be a side effect of some antipsychotic medications, it is not a prominent side effect of ziprasidone. Dry mouth and increased appetite are also not typically linked to ziprasidone use.

4. A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?

• A. Initiate a second intravenous access site
• B. Prepare to initiate cardiopulmonary resuscitation
• C. Determine the results of the drug toxicity screen
• D. Administer an additional dose of naloxone

Correct answer: D

Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.

5. A client with a history of atrial fibrillation is prescribed amiodarone. The nurse should monitor for which potential side effect?

• A. Pulmonary toxicity
• B. Liver toxicity
• C. Thyroid dysfunction
• D. Bradycardia

Correct answer: A

Rationale: Corrected Rationale: Amiodarone is known to cause pulmonary toxicity, which can manifest as respiratory symptoms. Monitoring for signs such as cough, dyspnea, or chest pain is essential to detect this serious side effect early and prevent further complications. Choices B, C, and D are incorrect because while amiodarone can also cause liver toxicity, thyroid dysfunction, and bradycardia, pulmonary toxicity is the most serious side effect that requires immediate attention due to its potential life-threatening consequences.

Similar Questions