Nursing Elites

1. A nurse is caring for a client in an outpatient facility who has been taking Acarbose for type 2 Diabetes Mellitus. Which of the following laboratory tests should the nurse plan to monitor?

• A. WBC
• B. Serum potassium
• C. Platelet count
• D. Liver function test

Correct answer: D

Rationale: The correct answer is D, Liver function test. Acarbose can cause liver toxicity when taken long-term. Monitoring liver function tests periodically is essential to assess for any potential liver damage. Choices A, B, and C are incorrect because Acarbose does not directly impact white blood cell count, serum potassium levels, or platelet count.

2. A client is receiving treatment with capecitabine. Which of the following findings should the nurse monitor?

• A. Hyperglycemia
• B. Hypocalcemia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Capecitabine is known to cause neutropenia as a common adverse effect due to bone marrow suppression. Neutropenia increases the risk of infections and requires close monitoring to prevent complications. Hyperglycemia (Choice A) is not typically associated with capecitabine. Hypocalcemia (Choice B) and Bradycardia (Choice D) are not commonly linked to capecitabine use, making them incorrect choices.

3. A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?

• A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
• C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• D. Draw a peak level at 0900 and a trough level at 2100.

Correct answer: C

Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.

4. A client is being taught about a new prescription for Escitalopram to treat generalized anxiety disorder. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication with food.
• B. I will monitor my blood sugar levels while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I can crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing Escitalopram, the client should taper the medication slowly according to a prescribed dosing schedule to reduce the risk of withdrawal syndrome. Abruptly stopping the medication can lead to withdrawal symptoms, so it is important to follow the healthcare provider's instructions for gradual discontinuation. Choices A, B, and D are incorrect because Escitalopram should not necessarily be taken with food, there is no direct correlation with blood sugar levels, and the medication should not be crushed before swallowing.

5. When teaching a client with a prescription for Loperamide for diarrhea, which instruction should the nurse include?

• A. Take the medication with a full glass of water.
• B. Avoid activities that require alertness.
• C. Expect abdominal pain and bloating.
• D. Take an additional dose after each loose stool.

Correct answer: B

Rationale: The correct instruction the nurse should include when teaching a client with a prescription for Loperamide is to 'Avoid activities that require alertness.' Loperamide can cause drowsiness, so clients should avoid such activities until they know how the medication affects them.

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