Nursing Elites

1. A client who takes Chlorpromazine for the treatment of Schizophrenia is due for a follow-up assessment. The nurse should expect the greatest improvement in which of the following manifestations? (Select all that apply.)

• A. Disorganized speech.
• B. Bizarre behavior.
• C. Impaired social interactions.
• D. Hallucinations.

Correct answer: A

Rationale: When a client takes a conventional antipsychotic medication like chlorpromazine, the greatest improvement is typically seen in positive symptoms such as disorganized speech. These medications are more effective in managing positive symptoms like disorganized speech rather than negative symptoms like impaired social interactions or hallucinations. Therefore, the nurse should anticipate improvement in disorganized speech as a positive response to chlorpromazine treatment.

2. A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?

• A. Metformin
• B. Metoprolol
• C. Lisinopril
• D. Insulin

Correct answer: A

Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.

3. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)

• A. Thrombocyte count.
• B. Hematocrit.
• C. Amylase.
• D. Liver function tests.

Correct answer: A

Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.

4. When assessing a client taking Lithium Carbonate for Bipolar disorder, which finding should the nurse recognize as a possible indication of toxicity to this medication?

• A. Severe hypertension
• B. Coarse tremors
• C. Constipation
• D. Muscle spasm

Correct answer: B

Rationale: The correct answer is B: Coarse tremors. Coarse tremors are a common sign of Lithium toxicity. Monitoring for tremors is crucial as they can indicate a potentially serious complication that requires immediate intervention. While other options such as severe hypertension, constipation, and muscle spasm may be symptoms of various conditions, they are not typically associated with Lithium toxicity. Severe hypertension is not a common sign of Lithium toxicity; constipation is not a typical symptom of Lithium toxicity either, and muscle spasm is not a direct indicator of Lithium toxicity.

5. A client has a new prescription for Verapamil to treat angina. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Muscle pain
• B. Dry cough
• C. Peripheral edema
• D. Increased urination

Correct answer: C

Rationale: Verapamil, a calcium channel blocker, can cause peripheral edema due to vasodilation. Clients should monitor for this adverse effect characterized by swelling in the extremities. Muscle pain (choice A) is not a common adverse effect of Verapamil. Dry cough (choice B) is more commonly associated with ACE inhibitors. Increased urination (choice D) is not a typical adverse effect of Verapamil. Therefore, the correct answer is monitoring for peripheral edema.

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