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. 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.

3. When reviewing a client's health record, a healthcare professional notes that the client is experiencing episodes of hypokalemia. Which of the following medications should be identified as a cause of the client's hypokalemia?

• A. Captopril
• B. Lisinopril
• C. Furosemide
• D. Spironolactone

Correct answer: C

Rationale: Furosemide, a loop diuretic, can lead to hypokalemia by increasing the excretion of potassium in the urine. This potassium loss can result in lower-than-normal levels of potassium in the body, leading to hypokalemia.

4. A client has a new prescription for Atenolol. Which of the following statements should be included by the healthcare provider?

• A. Take the medication with a high-fat meal.
• B. Monitor your heart rate before taking the medication.
• C. Expect a persistent cough.
• D. Avoid foods high in fiber.

Correct answer: B

Rationale: When a client is prescribed Atenolol, a beta-blocker, they should monitor their heart rate before taking the medication. It is crucial because if the heart rate is below 60 bpm, the client needs to contact their healthcare provider for further guidance and evaluation. Choices A, C, and D are incorrect. Atenolol does not need to be taken with a high-fat meal, does not typically cause a persistent cough, and there is no need to avoid foods high in fiber when taking this medication.

5. A healthcare professional is about to administer Propranolol to a patient. The healthcare professional takes the patient's apical pulse and documents it as 58 bpm. How should the healthcare professional proceed?

• A. Administer the medication as prescribed
• B. Administer half of the normal dose
• C. Consider the extended-release form of the medication
• D. Withhold administration of the medication and notify the healthcare provider

Correct answer: D

Rationale: When a patient's apical pulse is 58 bpm, it is below the normal range. Propranolol is a beta-blocker that can further lower the heart rate. Therefore, it is crucial to withhold the medication and notify the healthcare provider to evaluate the patient's condition. Administering Propranolol in this situation can exacerbate bradycardia, leading to serious complications. Choosing to administer the medication as prescribed (Choice A) can put the patient at risk. Administering half of the normal dose (Choice B) without healthcare provider guidance is not appropriate in this case. Considering the extended-release form of the medication (Choice C) does not address the immediate concern of bradycardia and is not the best course of action.

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