Nursing Elites

1. A client is receiving Cefotaxime IV for a severe infection. Which finding indicates a potentially serious adverse reaction to this medication that the nurse should report to the provider?

• A. Diaphoresis
• B. Epistaxis
• C. Diarrhea
• D. Alopecia

Correct answer: C

Rationale: Diarrhea is an adverse effect of cefotaxime and other cephalosporins that requires reporting to the provider. Severe diarrhea might indicate the client has developed antibiotic-associated pseudomembranous colitis, which could be life-threatening. Diaphoresis, epistaxis, and alopecia are not typically associated with cefotaxime use and are less likely to indicate a serious adverse reaction necessitating immediate reporting.

2. A client has a new prescription for Labetalol. Which of the following instructions should be provided?

• A. Take the medication with food.
• B. Monitor your blood glucose levels.
• C. Expect a rapid heart rate.
• D. Increase your intake of high-sodium foods.

Correct answer: A

Rationale: The correct answer is A: Take the medication with food. Labetalol should be taken with food to increase absorption and reduce the risk of orthostatic hypotension. Taking it with food helps in better absorption and minimizes the potential drop in blood pressure when standing up, which can occur with this medication. Choice B is incorrect as Labetalol is not primarily associated with affecting blood glucose levels. Choice C is incorrect as Labetalol is a beta-blocker that would actually lower heart rate, not increase it. Choice D is incorrect because increasing intake of high-sodium foods could counteract the antihypertensive effects of Labetalol.

3. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

4. A healthcare provider in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings are indicative of this condition?

• A. Insidious onset of painless loss of vision
• B. Gradual reduction in peripheral vision
• C. Severe pain around the eyes
• D. Intraocular pressure of 12mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a characteristic symptom of acute angle-closure glaucoma. This intense pain is typically accompanied by other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. The acute rise in intraocular pressure leads to these symptoms, indicating a medical emergency that requires immediate attention to prevent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more suggestive of conditions like age-related macular degeneration or diabetic retinopathy. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12mm Hg is within the normal range and not indicative of the acute rise seen in angle-closure glaucoma.

5. When teaching a client with a new prescription for Amiodarone, which instruction should the nurse include?

• A. Take this medication with meals.
• B. Avoid drinking grapefruit juice.
• C. Take this medication at bedtime.
• D. Increase your intake of sodium-rich foods.

Correct answer: B

Rationale: The correct instruction is to avoid drinking grapefruit juice when taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the drug and potentially causing adverse effects like cardiac toxicity. Choices A, C, and D are incorrect because taking Amiodarone with meals, at bedtime, or increasing sodium-rich foods intake are not relevant instructions for this medication.

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