Nursing Elites

1. A client has a new prescription for Prednisone. Which of the following laboratory values should be monitored by the healthcare provider?

• A. Serum potassium
• B. Serum calcium
• C. Serum sodium
• D. Serum glucose

Correct answer: D

Rationale: When a client is prescribed Prednisone, monitoring serum glucose levels is essential. Prednisone, a corticosteroid, can lead to hyperglycemia. Therefore, regular monitoring of serum glucose helps in detecting and managing any potential hyperglycemic effects of the medication. Monitoring serum potassium, calcium, or sodium is not typically required when a client is on Prednisone unless there are specific risk factors or concerns related to these electrolytes.

2. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin sublingual tablets involves taking one tablet at the onset of chest pain and repeating every 5 minutes for up to three doses. This protocol helps in managing angina episodes effectively. Choice A suggests taking a tablet every 15 minutes until pain relief, which may delay appropriate intervention. Choice C, taking a tablet at bedtime, is not suitable for immediate relief during angina attacks. Choice D, taking a tablet on an empty stomach, is unrelated to the correct administration of Nitroglycerin sublingual tablets.

3. A client is being taught by a nurse about long-term use of oral prednisone for chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Weight Gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is a common adverse effect of long-term prednisone use. Prednisone, a corticosteroid medication, can cause fluid retention and increased appetite, leading to weight gain. Nervousness (choice B) is more commonly associated with stimulant medications or excessive caffeine intake. Bradycardia (choice C) refers to a slow heart rate and is not a typical adverse effect of prednisone. Constipation (choice D) is not a common side effect of prednisone; in fact, prednisone is more likely to cause gastrointestinal issues such as increased appetite and weight gain.

4. A client has a new prescription for Lisinopril. Which of the following adverse effects should the nurse monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: The correct answer is 'Dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. If the client experiences this, it is important to notify the healthcare provider for further evaluation and management.

5. A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?

• A. Remove the prior dose before applying a new dose.
• B. Rub the ointment directly into the skin until it is no longer visible.
• C. Cover the applied ointment with a clean gauze pad.
• D. Apply the ointment to the same skin area each time.

Correct answer: A

Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.

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