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 requests information on the use of Feverfew. Which of the following responses should the nurse make?

• A. It is used to treat skin infections.
• B. It can decrease the frequency of migraine headaches.
• C. It can lessen nasal congestion in the common cold.
• D. It can relieve nausea of morning sickness during pregnancy.

Correct answer: B

Rationale: The correct response is B: Feverfew is commonly used to decrease the frequency of migraine headaches. However, it is important to note that it has not been proven to relieve an existing migraine headache. Choices A, C, and D are incorrect as Feverfew is not typically used for treating skin infections, lessening nasal congestion in the common cold, or relieving nausea of morning sickness during pregnancy.

3. A client is admitted for a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine is known to produce psychological effects, such as hallucinations. Therefore, individuals with schizophrenia are at increased risk of experiencing exacerbation of their symptoms if given Ketamine, making it a contraindication for its use as an intravenous anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for Ketamine use as an intravenous anesthetic.

4. A client has a prescription for Alendronate. Which of the following instructions should the nurse include?

• A. Take this medication before bed.
• B. Take the medication with food.
• C. Sit upright for at least 30 minutes after taking the medication.
• D. Expect to have frequent headaches while on this medication.

Correct answer: C

Rationale: The correct instruction for a client prescribed Alendronate is to sit upright for at least 30 minutes after taking the medication. Alendronate can cause esophageal irritation, and maintaining an upright position helps prevent this adverse effect by reducing the risk of reflux of the medication into the esophagus. Choice A is incorrect because Alendronate should be taken in the morning, at least 30 minutes before the first food, beverage, or medication of the day with a full glass of plain water. Choice B is incorrect because Alendronate should not be taken with food. Choice D is incorrect because frequent headaches are not a common side effect of Alendronate.

5. A patient is being discharged with a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bedtime.
• B. Monitor for increased blood pressure.
• C. Take the medication with food.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct instruction the nurse should include is to monitor for leg cramps. Leg cramps can be a sign of hypokalemia, which is a potential adverse effect of Hydrochlorothiazide. By monitoring for leg cramps, the patient can detect signs of low potassium levels and report them to the healthcare provider promptly. This proactive approach helps prevent complications associated with hypokalemia. The other options are incorrect because taking Hydrochlorothiazide before bedtime or with food is not specific to the medication's adverse effects. Monitoring for increased blood pressure is not typically a common adverse effect of this medication.

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