Nursing Elites

1. When caring for a client prescribed Lithium, which laboratory value should the nurse monitor to assess for potential toxicity?

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

Correct answer: B

Rationale: The nurse should monitor the client's serum lithium levels to ensure they are within the therapeutic range and to assess for potential toxicity. Monitoring serum lithium levels is crucial because lithium has a narrow therapeutic range, and levels outside this range can lead to toxicity, which can be life-threatening. Therefore, regular monitoring is essential to prevent adverse effects and ensure the medication's effectiveness.

2. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

• A. 2+ deep tendon reflexes
• B. 2+ pedal edema
• C. 24 mL/hr urinary output
• D. Respirations 12/min

Correct answer: C

Rationale: In a client receiving Magnesium Sulfate IV continuous infusion for Preeclampsia, a urinary output less than 25 to 30 mL/hr is indicative of magnesium sulfate toxicity and should be promptly reported to the provider for further evaluation and management. Therefore, the correct answer is C. Option A, 2+ deep tendon reflexes, are expected findings in a client receiving magnesium sulfate and do not require immediate reporting. Option B, 2+ pedal edema, is a common symptom of preeclampsia and typically does not require immediate intervention. Option D, respirations 12/min, are within the normal range and do not indicate an immediate need for reporting to the provider.

3. A client is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity?

• A. Light yellow urine
• B. Report of tinnitus
• C. Productive cough
• D. Blue-gray skin discoloration

Correct answer: D

Rationale: Blue-gray skin discoloration is a common sign of Amiodarone toxicity, known as blue-gray discoloration, which can affect areas like the face, neck, or hands. It is important to monitor for this side effect, as it can be a visible indicator of potential toxicity. Choices A, B, and C are incorrect. Light yellow urine is not typically associated with Amiodarone toxicity. Tinnitus is not a common manifestation of Amiodarone toxicity. A productive cough is not a recognized symptom of Amiodarone toxicity.

4. When starting therapy with Lisinopril, a client should be instructed to monitor for which of the following adverse effects?

• A. Tinnitus
• B. Diarrhea
• C. Cough
• D. Weight gain

Correct answer: C

Rationale: When starting therapy with Lisinopril, a client should be instructed to monitor for a persistent dry cough as an adverse effect. Lisinopril, an ACE inhibitor, commonly causes this cough as an adverse effect. It is important for the client to monitor for this symptom and notify their healthcare provider if it occurs. Choices A, B, and D are incorrect because tinnitus, diarrhea, and weight gain are not commonly associated adverse effects of Lisinopril.

5. A healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

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

Correct answer: A

Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause a non-productive cough due to its effect on bradykinin levels. The client should be advised to report this symptom to their healthcare provider to consider alternative treatments. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not typically associated with Enalapril use.

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