Nursing Elites

1. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take my medication as needed to alleviate symptoms
• B. I should take the medication in divided doses to ensure therapeutic drug levels
• C. I should take the medication in the morning to prevent insomnia
• D. I should take the medication on a full stomach

Correct answer: C

Rationale: Levothyroxine should be taken once in the morning to prevent insomnia and maintain therapeutic levels.

2. A client is receiving magnesium sulfate for the management of preeclampsia. Which of the following client assessments should the nurse monitor to prevent complications of therapy?

• A. Bowel sounds
• B. Deep tendon reflexes
• C. Oxygen saturation
• D. Fluid balance

Correct answer: B

Rationale: The correct answer is deep tendon reflexes. Monitoring deep tendon reflexes is crucial to assess for magnesium toxicity during therapy for preeclampsia. Magnesium sulfate can lead to neuromuscular blockade, reflected by decreased or absent deep tendon reflexes. Assessing bowel sounds (choice A) is important for gastrointestinal function but is not directly related to magnesium sulfate therapy. Oxygen saturation (choice C) is vital for respiratory status but is not specifically linked to magnesium sulfate administration. Fluid balance (choice D) is essential but does not directly correlate with monitoring for complications of magnesium sulfate therapy in the context of preeclampsia.

3. A client is prescribed spironolactone. Which of the following findings would indicate an adverse effect of this medication?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: A

Rationale: Hyperkalemia is the correct answer as it is an adverse effect associated with spironolactone, a potassium-sparing diuretic. Spironolactone works by blocking the aldosterone receptor in the distal convoluted tubule, leading to decreased potassium excretion and potential hyperkalemia. Hypokalemia (choice B) and hyponatremia (choice C) are not typically associated with spironolactone use. Hypernatremia (choice D) is also an unlikely finding with spironolactone.

4. A nurse is administering metformin to a client with type 2 diabetes. Which of the following adverse effects should the nurse monitor for in this client?

• A. Diarrhea
• B. Hyperglycemia
• C. Hypoglycemia
• D. Lactic acidosis

Correct answer: D

Rationale: The correct answer is D, Lactic acidosis. Lactic acidosis is a rare but serious adverse effect of metformin use. Metformin is not known to cause hyperglycemia or hypoglycemia. Diarrhea is a common gastrointestinal side effect of metformin but is not as serious as lactic acidosis, which requires immediate medical attention.

5. A nurse is reviewing the medication class benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients?

• A. A client with glaucoma
• B. A client with renal failure
• C. A client with hypertension
• D. A client with insomnia

Correct answer: A

Rationale: The correct answer is A. Benzodiazepines should be used cautiously in clients with glaucoma because these medications can increase intraocular pressure. Choices B, C, and D are incorrect because renal failure, hypertension, and insomnia are not contraindications for administering benzodiazepines.

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