Nursing Elites

1. A client with liver cirrhosis is receiving lactulose for hepatic encephalopathy. Which finding indicates the medication is effective?

• A. The client's level of consciousness improves.
• B. The client's ammonia level decreases.
• C. The client has three bowel movements daily.
• D. The client's liver enzymes return to normal.

Correct answer: B

Rationale: The correct answer is B: "The client's ammonia level decreases." In hepatic encephalopathy, elevated ammonia levels contribute to neurological symptoms. Lactulose works by promoting the excretion of ammonia in the stool, leading to decreased serum ammonia levels. Therefore, a decrease in ammonia levels indicates that lactulose is effectively reducing ammonia buildup, improving hepatic encephalopathy symptoms. Choices A, C, and D are incorrect because improvement in level of consciousness, bowel movements, or normalization of liver enzymes may not directly reflect the effectiveness of lactulose in reducing ammonia levels and improving hepatic encephalopathy.

2. The healthcare provider prescribes a sedative for a client with severe hypothyroidism. What is the best action for the nurse to take?

• A. Affirm the nurse's plan to review the prescription with the provider.
• B. Administer the sedative as prescribed.
• C. Advise the nurse to administer the medication as prescribed.
• D. Offer to administer the medication since the nurse is concerned.

Correct answer: A

Rationale: The correct answer is to affirm the nurse's plan to review the prescription with the provider. Sedatives can worsen symptoms of hypothyroidism, so it is crucial to ensure the safety of the prescribed medication. Administering the sedative without further consultation could lead to adverse effects. Simply advising the nurse to administer the medication without addressing the need for review is not the best course of action. Offering to administer the medication without proper assessment or consulting the provider is not appropriate and could potentially harm the client.

3. A client with hypothyroidism is experiencing severe lethargy and cold intolerance. What action should the nurse take?

• A. Increase the dose of levothyroxine.
• B. Administer a PRN dose of antipyretic medication.
• C. Provide a warm blanket and increase the room temperature.
• D. Increase the client's fluid intake to avoid dehydration.

Correct answer: A

Rationale: The correct answer is to increase the dose of levothyroxine. In hypothyroidism, the body does not produce enough thyroid hormone, leading to symptoms like lethargy and cold intolerance. Increasing the dose of levothyroxine, which is a synthetic thyroid hormone replacement, helps correct the deficiency and alleviates the symptoms. Choice B, administering antipyretic medication, is incorrect as antipyretics are used to reduce fever, not treat hypothyroidism symptoms. Choice C, providing a warm blanket and increasing room temperature, may provide temporary comfort but does not address the underlying hormonal deficiency. Choice D, increasing fluid intake, is important for overall health but does not directly address the symptoms of hypothyroidism.

4. A client with atrial fibrillation is prescribed warfarin. Which instruction should the nurse include in the teaching?

• A. Maintain a consistent intake of leafy green vegetables
• B. Use an electric razor when shaving
• C. Monitor blood pressure daily
• D. Avoid eating bananas and oranges

Correct answer: B

Rationale: Clients on warfarin are at increased risk of bleeding due to its anticoagulant effects. Using an electric razor reduces the risk of cuts and bleeding, which is an important safety precaution. While leafy greens should not be avoided, their intake should be consistent to maintain a stable level of vitamin K in the body. Monitoring blood pressure daily is important for other conditions but not directly related to warfarin therapy. Avoiding bananas and oranges is not a standard instruction for clients on warfarin.

5. An adolescent client with meningococcal meningitis is receiving a continuous IV infusion of penicillin G. How many mL/hour should the nurse program the infusion pump to deliver?

• A. 83
• B. 85
• C. 87
• D. 90

Correct answer: A

Rationale: The correct answer is A: 83. The pharmacy provided the infusion at 10 million units per liter, which requires a rate of 83 mL/hour. To calculate this, multiply the dosage by the volume of the IV solution and divide by the concentration of the IV solution in million units: 10 million units per liter x 8.3 L = 83 mL/hour. Choices B, C, and D are incorrect as they do not align with the calculation based on the given information.

Similar Questions