Nursing Elites

1. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

• A. Hearing examination
• B. Glucose tolerance test
• C. Electrocardiogram
• D. Pulmonary function tests

Correct answer: C

Rationale: The correct answer is C: Electrocardiogram. Amitriptyline can cause cardiac arrhythmias, so an electrocardiogram is necessary before starting treatment. A hearing examination (choice A) is not required before initiating amitriptyline. A glucose tolerance test (choice B) is not indicated for starting this medication. Pulmonary function tests (choice D) are not necessary before initiating amitriptyline for depression.

2. A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Thrombophlebitis
• B. Hyperactive reflexes
• C. Muscle weakness
• D. Hypoglycemia

Correct answer: C

Rationale: The correct answer is C: Muscle weakness. Chlorothiazide, a thiazide diuretic, can lead to hypokalemia, which can cause muscle weakness. Thrombophlebitis (choice A) is not typically associated with chlorothiazide use. Hyperactive reflexes (choice B) and hypoglycemia (choice D) are also not commonly linked to this medication. Therefore, monitoring for muscle weakness is crucial when a client is prescribed chlorothiazide.

3. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?

• A. Increases blood pressure
• B. Prevents esophageal bleeding
• C. Decreases heart rate
• D. Reduces ammonia levels

Correct answer: D

Rationale: The correct answer is D: Reduces ammonia levels. Lactulose is used to reduce blood ammonia levels in clients with hepatic encephalopathy. Options A, B, and C are incorrect because lactulose does not have the therapeutic effect of increasing blood pressure, preventing esophageal bleeding, or decreasing heart rate.

4. A client is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?

• A. Hypoglycemia
• B. Proteinuria
• C. Nasal congestion
• D. Visual disturbances

Correct answer: B

Rationale: The correct answer is B: Proteinuria. Proteinuria can indicate nephrotoxicity, a known adverse effect of gentamicin. Gentamicin is known to cause kidney damage, leading to proteinuria. Hypoglycemia is not typically associated with gentamicin use but may be related to insulin administration or other medical conditions. Nasal congestion is not a common adverse effect of gentamicin. Visual disturbances are also not typically reported with gentamicin use.

5. A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number)

• A. 5 mL
• B. 6 mL
• C. 4 mL
• D. 7 mL

Correct answer: A

Rationale: To calculate the amount of amoxicillin in mL needed per dose, we can use the formula: 50 mg/mL = 250 mg / X mL. Cross multiply to solve for X: 50X = 250. Divide both sides by 50 to find X, which equals 5 mL per dose. Therefore, the nurse should administer 5 mL of amoxicillin per dose. Choice B, 6 mL, is incorrect as it does not match the calculated result. Choice C, 4 mL, is incorrect as it is too low based on the calculation. Choice D, 7 mL, is incorrect as it is too high based on the calculation.

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