Nursing Elites

1. A nurse is providing client education regarding lithium therapy. Which of the following instructions should the nurse include?

• A. Take with food to decrease nausea
• B. Avoid excessive intake of caffeinated beverages
• C. Monitor for signs of dehydration
• D. Restrict salt intake to prevent water retention

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to avoid excessive intake of caffeinated beverages as they can interfere with lithium levels. Option A is incorrect as lithium is usually recommended to be taken on an empty stomach. Option C is not directly related to lithium therapy. Option D is not a typical instruction for lithium therapy.

2. A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?

• A. Notify your provider if you experience restlessness or spasms of the face or neck
• B. This medication can cause insomnia
• C. Decrease your fluid intake while taking this medication
• D. This medication can cause urinary frequency

Correct answer: A

Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can lead to extrapyramidal symptoms such as restlessness or facial spasms, which are serious and require immediate medical attention. Choices B, C, and D are incorrect. Insomnia is not a common side effect of metoclopramide. Increasing fluid intake is usually recommended to prevent dehydration caused by potential side effects like diarrhea. Urinary frequency is not a typical side effect associated with metoclopramide.

3. When administering amlodipine to a client with hypertension, what adverse effect should the nurse monitor for?

• A. Constipation
• B. Facial flushing
• C. Hypotension
• D. Jaundice

Correct answer: C

Rationale: The correct answer is C, Hypotension. Amlodipine is a calcium channel blocker commonly used to treat hypertension. One of the main adverse effects of amlodipine is hypotension, leading to low blood pressure. The nurse should monitor the client for signs of hypotension such as dizziness, lightheadedness, or fainting. Choices A, B, and D are incorrect because constipation, facial flushing, and jaundice are not typically associated with amlodipine administration.

4. A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site?

• A. a 45-degree angle
• B. a 60-degree angle
• C. a 75-degree angle
• D. a 90-degree angle

Correct answer: D

Rationale: Intramuscular injections in the ventrogluteal site should be administered at a 90-degree angle. This angle ensures that the medication reaches the muscle tissue effectively. Angles less than 90 degrees can cause subcutaneous injection instead of intramuscular, leading to slower absorption of the medication. Angles greater than 90 degrees risk hitting bone or nerves, causing unnecessary pain or injury. Therefore, the correct angle for administering intramuscular injections in the ventrogluteal site is 90 degrees.

5. A client with an artificial heart valve is prescribed warfarin therapy. Which of the following laboratory values should the nurse monitor to assess the therapeutic effect of warfarin?

• A. Hemoglobin (Hgb)
• B. Prothrombin time (PT)
• C. Bleeding time
• D. Activated partial thromboplastin time (aPTT)

Correct answer: B

Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the clotting factors dependent on vitamin K, such as factors II, VII, IX, and X. The prothrombin time (PT) measures the extrinsic pathway and is used to monitor the therapeutic effects of warfarin therapy. Monitoring PT helps assess the time it takes for the blood to clot, ensuring that the anticoagulant effect is within the desired range. Choices A, C, and D are incorrect because hemoglobin (Hgb) measures the amount of hemoglobin in the blood, bleeding time assesses the time it takes for bleeding to stop, and activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin therapy.

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