Nursing Elites

1. A client has a new prescription for Metformin to treat type 2 diabetes. Which of the following laboratory results should be monitored?

• A. Hemoglobin A1C
• B. Liver function tests
• C. Electrolyte levels
• D. Kidney function

Correct answer: D

Rationale: Metformin is excreted by the kidneys, and impaired kidney function can lead to an increased risk of lactic acidosis, a serious side effect. Therefore, it is important to monitor kidney function regularly while a client is on Metformin. Hemoglobin A1C is used to monitor long-term glucose control, but kidney function is the priority for monitoring Metformin therapy.

2. When reviewing a client's health record, a nurse notes a new prescription for Lisinopril 10 mg PO once daily. The nurse should identify this as which type of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates medications to be administered on a regular schedule without a termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily falls under a routine prescription, meaning the nurse will administer this medication daily until the provider discontinues it. Choices A, B, and D are incorrect: A 'single' prescription is for a one-time dose, 'stat' prescriptions are for immediate administration, and 'standing' prescriptions are pre-authorized for administration as needed within specified parameters.

3. A client in the operating room received a dose of Succinylcholine, leading to muscle rigidity and a sudden rise in body temperature. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: C

Rationale: Muscle rigidity and a sudden rise in temperature are indicative of malignant hyperthermia, a potential complication of succinylcholine. Dantrolene is the drug of choice to treat malignant hyperthermia as it acts on skeletal muscles to reduce metabolic activity and counteract the symptoms. Neostigmine (Choice A) is used to reverse the effects of non-depolarizing neuromuscular blocking agents, not for malignant hyperthermia. Naloxone (Choice B) is an opioid antagonist used for opioid overdose. Vecuronium (Choice D) is a non-depolarizing neuromuscular blocking agent and is not the appropriate medication for malignant hyperthermia.

4. A healthcare professional is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis Gravidarum. The healthcare professional should clarify which of the following parts of the prescription with the provider?

• A. Name
• B. Dosage
• C. Route
• D. Frequency

Correct answer: D

Rationale: The prescription lacks the frequency of medication administration, which is crucial for ensuring appropriate use. In this case, the frequency of when the medication can be taken needs to be clarified with the provider to provide safe and effective care for the client with Hyperemesis Gravidarum.

5. A client has a new prescription for Iron supplements. Which of the following instructions should be included in the teaching?

• A. Take the medication with a glass of orange juice.
• B. Avoid taking the medication with milk.
• C. Increase fiber intake to prevent constipation.
• D. Expect stools to be dark.

Correct answer: C

Rationale: The correct answer is to increase fiber intake to prevent constipation when taking iron supplements. Iron supplements can lead to constipation as a common side effect. Increasing fiber intake helps promote healthy bowel movements and counteracts the constipating effects of iron. Choice A is incorrect because iron absorption is hindered by calcium found in milk. Choice B is incorrect as orange juice enhances iron absorption due to its vitamin C content. Choice D is incorrect as iron supplements can cause stools to appear dark, not bright red.

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