Nursing Elites

1. Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?

• A. Potassium level
• B. Creatinine level
• C. Cholesterol level
• D. Blood urea nitrogen

Correct answer: A

Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.

2. A client with chronic pain is prescribed transdermal fentanyl (Duragesic) patches. Which instruction should the nurse include in the teaching plan?

• A. Apply the patch to a different site each time.
• B. Avoid using heating pads over the patch.
• C. Change the patch every 72 hours.
• D. Remove the old patch before applying the new one.

Correct answer: B

Rationale: Clients using transdermal fentanyl (Duragesic) patches should avoid using heating pads over the patch as heat can increase the release of the medication, potentially leading to overdose. The patch should be applied to a different site each time, changed every 72 hours, and the old patch should be removed before applying a new one to prevent accidental overdose or excessive drug absorption.

3. Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with prednisone?

• A. An additional dose of prednisone daily
• B. A decreased amount of daily Humulin NPH insulin
• C. An increased amount of daily Humulin NPH insulin
• D. The addition of an oral hypoglycemic medication daily

Correct answer: C

Rationale: When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.

4. A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:

• A. Treat thyroid storm.
• B. Prevent cardiac irritability.
• C. Treat hypocalcemic tetany.
• D. Stimulate the release of parathyroid hormone.

Correct answer: C

Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.

5. The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

• A. Fever
• B. Diarrhea
• C. Complaints of nausea and vomiting
• D. Crackles on auscultation of the lungs

Correct answer: D

Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications. Fever, diarrhea, and complaints of nausea and vomiting are common side effects of daunorubicin but do not specifically indicate a toxic effect like cardiotoxicity.

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