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 healthcare professional is reviewing the laboratory results of a client who is taking Lithium for Bipolar Disorder. Which of the following findings should the healthcare professional report to the provider immediately?

• A. Lithium level of 1.0 mEq/L
• B. Potassium level of 3.5 mEq/L
• C. Sodium level of 140 mEq/L
• D. Creatinine level of 1.0 mg/dL

Correct answer: D

Rationale: A creatinine level of 1.0 mg/dL should be reported to the provider immediately. While a lithium level of 1.0 mEq/L falls within the therapeutic range, a creatinine level of 1.0 mg/dL could suggest early signs of kidney dysfunction, especially concerning in a client on long-term lithium therapy. It is crucial to monitor kidney function closely because lithium can be nephrotoxic over time. Elevated creatinine levels may indicate impaired kidney function and should prompt immediate reporting to the healthcare provider. Potassium and sodium levels within normal range are not immediate concerns when compared to potential kidney issues.

3. What is a severe adverse effect of iron supplementation?

• A. Seizures
• B. Dry mouth
• C. Edema
• D. Serotonin syndrome

Correct answer: A

Rationale: A severe adverse effect of iron supplementation is seizures. Iron toxicity can lead to symptoms such as abdominal pain, vomiting, bloody diarrhea, lethargy, and in severe cases, seizures. It is important for individuals taking iron supplements to follow recommended dosages to prevent adverse effects.

4. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

• A. Increased renal secretion
• B. Increased medication-metabolizing enzymes
• C. Liver failure
• D. Peripheral vascular disease

Correct answer: C

Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.

5. A client has a new diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?

• A. Colchicine
• B. Hydroxychloroquine
• C. Auranofin
• D. Duloxetine

Correct answer: D

Rationale: The correct answer is D, Duloxetine. Duloxetine is a serotonin-norepinephrine reuptake inhibitor commonly used to manage fibromyalgia. It helps in reducing pain and improving mood in individuals with this condition. Colchicine (Choice A) is primarily used to treat gout, while Hydroxychloroquine (Choice B) and Auranofin (Choice C) are medications used to manage conditions like rheumatoid arthritis and lupus, not fibromyalgia.

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