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 active pulmonary tuberculosis (TB) is to be started on intravenous rifampin therapy. The client should be informed by the nurse that this medication can cause which of the following adverse effects?

• A. Constipation
• B. Black-colored stools
• C. Staining of teeth
• D. Body secretions turning a red-orange color

Correct answer: D

Rationale: The correct answer is D: Body secretions turning a red-orange color. Rifampin is known to cause body secretions, such as urine, sweat, tears, and sputum, to turn a harmless red-orange color. This is a common and expected side effect of rifampin therapy. Choices A, B, and C are incorrect. Constipation is not a common adverse effect of rifampin. Black-colored stools and staining of teeth are not associated with rifampin therapy. It is important for the nurse to educate the client about the harmless red-orange discoloration that may occur with this medication.

3. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications?

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

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers, such as the one the client received. It works by inhibiting the breakdown of acetylcholine, thereby enhancing neuromuscular transmission and reversing muscle weakness caused by the neuromuscular blocking agent.

4. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

5. A client has a new prescription for Ranitidine. Which of the following instructions should the nurse include?

• A. Take the medication with an antacid.
• B. Avoid drinking coffee while taking this medication.
• C. Take the medication at bedtime.
• D. Stop the medication if you develop a headache.

Correct answer: C

Rationale: The correct instruction for a client prescribed Ranitidine is to take the medication at bedtime. Ranitidine is best taken at bedtime as it helps decrease the production of stomach acid during the night, providing optimal relief for conditions like heartburn or acid indigestion.

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