Nursing Elites

1. A client is receiving Gentamicin. Which of the following laboratory values should the nurse monitor to assess for nephrotoxicity?

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

Correct answer: B

Rationale: When a client is receiving Gentamicin, the nurse should monitor serum creatinine levels to assess for nephrotoxicity. Gentamicin is known to potentially cause nephrotoxicity, leading to impaired kidney function. Monitoring serum creatinine levels helps in early detection of any kidney damage or dysfunction. Serum sodium, serum potassium, and serum glucose levels are not directly related to nephrotoxicity caused by Gentamicin, so they are not the appropriate values to monitor in this case.

2. When teaching a client with a prescription for Vancomycin, which instruction should the nurse include?

• A. Expect red man syndrome during treatment.
• B. Take the medication with a full glass of water.
• C. Increase your intake of potassium-rich foods.
• D. Monitor for hearing loss while taking this medication.

Correct answer: D

Rationale: The correct answer is D. Vancomycin is known to cause ototoxicity, which can result in hearing loss. Therefore, it is important for clients to monitor for any changes in their hearing while taking this medication and promptly report any issues to their healthcare provider for further evaluation and management. Choices A, B, and C are incorrect because red man syndrome is associated with rapid infusion of Vancomycin, not a common side effect during treatment; taking the medication with a full glass of water is a general instruction for many medications but not specific to Vancomycin; and increasing potassium-rich foods is not directly related to Vancomycin therapy.

3. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

4. At what amount does Acetaminophen stop effectively controlling pain?

• A. Over 1,000 mg
• B. 750 mg
• C. Over 1,500 mg
• D. 150 mg

Correct answer: A

Rationale: Acetaminophen is known to lose its effectiveness in controlling pain beyond a dosage of 1,000 mg. Taking more than 1,000 mg will not provide additional pain relief but can increase the risk of adverse effects. Choice B (750 mg) is incorrect because this amount is within the typical recommended dose range for Acetaminophen. Choice C (Over 1,500 mg) is incorrect as it suggests a higher dose than the point at which Acetaminophen starts to lose its effectiveness. Choice D (150 mg) is too low a dose to effectively control pain for most adults.

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

• A. Take the medication with food.
• B. Monitor your blood pressure weekly.
• C. Notify your provider if you develop a persistent cough.
• D. Avoid using salt substitutes to prevent hyperkalemia.

Correct answer: C

Rationale: Clients prescribed with Captopril, an ACE inhibitor, are at risk of developing a persistent cough as a common adverse effect. It is essential for the client to inform their healthcare provider promptly if this side effect occurs to evaluate the need for a medication change or adjustment.

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