Nursing Elites

1. A client's serum Calcium is 8.8 mg/dL. Which of the following medications should the nurse anticipate administering to this client?

• A. Calcitonin-salmon
• B. Calcium carbonate
• C. Zoledronic acid
• D. Ibandronate

Correct answer: B

Rationale: The client's serum calcium level is below the expected reference range. In this case, the appropriate medication to anticipate administering is Calcium carbonate, an oral form of calcium used to increase serum calcium levels to the expected reference range.

2. When caring for a client prescribed warfarin, which laboratory test should the nurse monitor to evaluate the therapeutic effect of the medication?

• A. aPTT
• B. Platelet count
• C. BUN
• D. PT/INR

Correct answer: D

Rationale: The correct laboratory test to monitor the therapeutic effect of warfarin is the PT/INR. Warfarin affects blood clotting, and the PT/INR levels indicate the effectiveness of the medication in preventing clot formation. Therefore, monitoring PT/INR levels helps ensure that the client is within the therapeutic range and is protected from potential complications related to clotting. Choice A (aPTT) is incorrect because while it measures the clotting time, it is not the preferred test for monitoring warfarin therapy. Choice B (Platelet count) is incorrect as it assesses the number of platelets and not the medication's therapeutic effect. Choice C (BUN) is unrelated to monitoring the effects of warfarin therapy and is primarily used to assess kidney function.

3. A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?

• A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
• C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• D. Draw a peak level at 0900 and a trough level at 2100.

Correct answer: C

Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.

4. While caring for a client taking Propylthiouracil, for which of the following adverse effects should the nurse monitor?

• A. Bradycardia
• B. Insomnia
• C. Heat intolerance
• D. Weight loss

Correct answer: A

Rationale: When a client is taking Propylthiouracil, the nurse should monitor for bradycardia as it is an adverse effect of this medication. Propylthiouracil can lead to a decrease in heart rate, which is known as bradycardia. Monitoring for this adverse effect is crucial to ensure the client's safety and well-being while on this medication. The other options, such as insomnia, heat intolerance, and weight loss, are not commonly associated adverse effects of Propylthiouracil. Therefore, they are incorrect choices for monitoring while the client is on this medication.

5. A client has a new prescription for Calcitonin-salmon for Osteoporosis. Which of the following tests should the client expect before beginning this medication?

• A. Skin test for allergy to the medication
• B. ECG to rule out cardiac dysrhythmias
• C. Mantoux test to rule out exposure to tuberculosis
• D. Liver function tests to assess risk for medication toxicity

Correct answer: A

Rationale: Before initiating Calcitonin-salmon, a skin test for allergy to the medication may be performed to prevent anaphylactic reactions. Allergic reactions can occur due to sensitivities to the drug, particularly in individuals with fish allergies. Therefore, it is essential for healthcare providers to assess the client's potential allergic response to Calcitonin-salmon through a skin test. The other options are not relevant in this context. An ECG is not typically required before starting Calcitonin-salmon for Osteoporosis, nor is a Mantoux test or liver function tests.

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