Nursing Elites

1. Before administering lithium to a client with bipolar disorder who has been taking the medication for 1 year, the nurse should check to see that which of the following tests has been completed?

• A. Thyroid hormone assay
• B. Liver function tests
• C. Erythrocyte sedimentation rate
• D. Brain natriuretic peptide

Correct answer: A

Rationale: The correct answer is to check the thyroid hormone assay. Long-term lithium use can result in thyroid dysfunction, making it crucial to monitor the client's thyroid function regularly to detect any abnormalities early and prevent potential complications. Liver function tests (choice B) are not specifically associated with lithium therapy. Erythrocyte sedimentation rate (choice C) is a nonspecific test for inflammation and not directly related to lithium therapy. Brain natriuretic peptide (choice D) is a test used to diagnose heart failure and is not relevant to monitoring lithium therapy.

2. A client has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

• A. Increase intake of protein-rich foods.
• B. Expect muscle twitching to occur.
• C. Take this medication with food.
• D. Anticipate relief of manifestations in 24 hours.

Correct answer: C

Rationale: The correct instruction for the nurse to include is to advise the client to take Levodopa/Carbidopa with food. This recommendation helps reduce gastrointestinal side effects commonly associated with this medication. Food can help minimize nausea and other stomach-related issues that may occur when taking Levodopa/Carbidopa. Options A, B, and D are incorrect. Increasing intake of protein-rich foods is not necessary with this medication. Muscle twitching is not an expected side effect of Levodopa/Carbidopa. Anticipating relief of manifestations in 24 hours is unrealistic as it may take days to weeks for the full therapeutic effect of the medication to be achieved.

3. A client has a new prescription for transdermal patches. Which statement should the client make to indicate understanding of the instructions?

• A. I will clean the site with an alcohol swab before applying the patch.
• B. I will rotate the application sites weekly.
• C. I will apply the patch to an area of skin with no hair.
• D. I will place the new patch on the site of the old patch.

Correct answer: C

Rationale: The correct answer is C. Applying the patch to a hairless area of skin is essential for optimal medication absorption. Hair can interfere with the patch's adherence and effectiveness. It is important for the client to choose a site without hair to ensure proper delivery of the medication. Choices A, B, and D are incorrect because cleaning the site with an alcohol swab (Choice A) is a good practice but not the most crucial aspect for transdermal patch application. Rotating application sites weekly (Choice B) is more relevant for injections to prevent skin irritation or breakdown. Placing the new patch on the site of the old patch (Choice D) can lead to skin irritation and poor absorption due to a build-up of medication.

4. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The healthcare professional should administer IV Hydromorphone slowly over 5 minutes to reduce the risk of hypotension and respiratory depression. Rapid administration can lead to adverse effects due to its potency. Choice B is incorrect because Naloxone is used as an antidote for opioid overdose, not routinely administered with Hydromorphone. Choice C is important but not specific to the administration of Hydromorphone. Choice D is incorrect as Hydromorphone is intended for intravenous use, not subcutaneous injection.

5. A nurse is providing teaching to a client who has a new prescription for Metoprolol. Which of the following statements should the nurse include?

• A. This medication may make you feel dizzy at first.
• B. You should avoid foods that are high in fat.
• C. Take the medication in the morning.
• D. You may experience a rapid heart rate while taking this medication.

Correct answer: A

Rationale: Metoprolol, a beta-blocker, can cause dizziness, especially when starting the medication. The nurse should inform the client to change positions slowly to avoid dizziness and falls.

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