Nursing Elites

1. A client has a new prescription for Furosemide. Which of the following instructions should be included by the nurse?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction to include when a client is prescribed Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these potential adverse effects.

2. A client has a new prescription for Verapamil to treat angina. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of Verapamil?

• A. I am frequently constipated.
• B. I have been urinating more frequently.
• C. My skin is peeling.
• D. I have ringing in my ears.

Correct answer: A

Rationale: The correct answer is A: 'I am frequently constipated.' Constipation is a common adverse effect of Verapamil, a calcium channel blocker. Verapamil can slow down intestinal motility, leading to constipation as a side effect. Choices B, C, and D are not typically associated with adverse effects of Verapamil. Increased urination is not a common side effect, skin peeling is not related to Verapamil use, and ringing in the ears is not a typical adverse effect of this medication.

3. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.

4. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.

5. A client is receiving daily doses of Oprelvekin. Which of the following laboratory values should be monitored to determine the effectiveness of this medication?

• A. Hemoglobin
• B. Absolute neutrophil count
• C. Platelet count
• D. Total white blood cell count

Correct answer: C

Rationale: Oprelvekin is a medication that stimulates platelet production. Therefore, monitoring the platelet count is essential to assess the effectiveness of this drug. The expected outcome for oprelvekin therapy is a platelet count greater than 50,000/mm^3. Changes in platelet count can indicate the response to the medication and help in adjusting the treatment plan accordingly. Monitoring hemoglobin, absolute neutrophil count, or total white blood cell count is not directly related to the mechanism of action of Oprelvekin and therefore would not provide accurate information on the drug's effectiveness.

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