Nursing Elites

1. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.

2. What is the antidote for copper toxicity?

• A. Glucagon
• B. Aminocaproic acid
• C. Atropine
• D. Penicillamine

Correct answer: D

Rationale: Penicillamine is the specific chelating agent used for copper toxicity. It forms stable complexes with copper, which are then excreted in the urine. Glucagon is used for treating hypoglycemia, aminocaproic acid is used to treat bleeding disorders, and atropine is used as an antidote for certain types of poisoning, such as organophosphate toxicity.

3. When teaching a client with schizophrenia strategies to cope with anticholinergic effects of Fluphenazine, which of the following should the nurse suggest to minimize anticholinergic effects?

• A. Take the medication in the morning to prevent insomnia.
• B. Chew sugarless gum to moisten the mouth.
• C. Use cooling measures to decrease fever.
• D. Take an antacid to relieve nausea.

Correct answer: B

Rationale: The correct answer is B: 'Chew sugarless gum to moisten the mouth.' Chewing sugarless gum can help alleviate dry mouth, which is a common anticholinergic effect of Fluphenazine. Dry mouth can be uncomfortable and affect the client's oral health. Options A, C, and D are incorrect because they do not directly address anticholinergic effects. Taking the medication in the morning to prevent insomnia (Option A) is unrelated to anticholinergic effects. Using cooling measures to decrease fever (Option C) is not a common anticholinergic effect of Fluphenazine. Taking an antacid to relieve nausea (Option D) does not specifically target anticholinergic effects.

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

• A. Take this medication before meals.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication before meals.' Omeprazole is a proton pump inhibitor that should be taken before meals to be most effective in reducing stomach acid production. Taking it before meals allows the medication to inhibit the proton pumps in the stomach when they are most active, leading to better control of acid secretion. Choice B is incorrect because taking Omeprazole with food may reduce its effectiveness as food can interfere with its absorption. Choice C is incorrect as Omeprazole is more effective when taken before meals. Choice D is incorrect as Omeprazole should not be taken with antacids as they can reduce its absorption.

5. The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?

• A. “I will check my weight regularly for any gain or loss.”
• B. “I’ll make sure to take my high blood pressure medications.”
• C. “I am attending a smoking cessation class.”
• D. “As long as I exercise, stress at my job will not bother me.”

Correct answer: D

Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.

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