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. The healthcare provider is discharging a patient with a new prescription for ranitidine (Zantac). Which information would be important to include in the discharge teaching?

• A. Thrombolytic thrombocytopenic purpura (TTP) may occur
• B. Aspirin should not be taken with this medication
• C. The patient may experience iron deficiency anemia
• D. The patient may experience restlessness

Correct answer: D

Rationale: The correct answer is D. It is important to include information that ranitidine may cause restlessness as a side effect in some patients. Educating the patient about possible side effects helps in early recognition and management, improving medication adherence and patient safety. Choices A, B, and C are incorrect because they do not pertain to common side effects or specific considerations related to ranitidine use.

3. Which assessment finding requires nursing intervention prior to the administration of medication?

• A. Apical pulse heard best at the pulmonic site
• B. Irregular apical pulse rhythm
• C. Presence of a systolic heart murmur
• D. Apical pulse rate of 50 beats/minute

Correct answer: D

Rationale: An apical pulse rate of 50 beats/minute indicates bradycardia, a heart rate below the normal range, which requires immediate nursing intervention before administering medication to address the potential impact of the bradycardia on the patient's overall condition.

4. A client with hypertension is prescribed clonidine. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Dizziness
• D. Hyperglycemia

Correct answer: A

Rationale: When a client is prescribed clonidine, the nurse should monitor for bradycardia as a potential side effect. Clonidine can lead to a decrease in heart rate, thus causing bradycardia. Monitoring the client's heart rate is crucial to detect and manage this adverse effect.

5. The client is being instructed on the correct technique for using... what to provide the client?

• A. Angle the tip of the inhaler upwards while spraying
• B. Hold one nostril closed while spraying the other nostril
• C. Avoid shaking the inhaler immediately before using
• D. Use the inhaler when first awakening in the morning

Correct answer: B

Rationale: The correct technique for using an inhaler for allergic rhinitis involves holding one nostril closed while spraying the other nostril to ensure proper delivery of the medication. This technique helps direct the medication into the nasal passages for optimal effectiveness. Choice A is incorrect as it refers to an incorrect technique for inhaler use. Choice C is incorrect as shaking the inhaler is often necessary to ensure proper mixing of the medication. Choice D is incorrect as the timing of inhaler use is typically based on individual preferences or healthcare provider recommendations, not specifically tied to the morning.

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