Nursing Elites

1. A healthcare provider is reviewing the medical history of a client who is scheduled for surgery and takes Warfarin daily. Which of the following laboratory results should the healthcare provider monitor?

• A. Potassium level
• B. INR
• C. BUN
• D. Platelet count

Correct answer: B

Rationale: The INR (International Normalized Ratio) is the most important lab value to monitor in a client taking warfarin. Warfarin is an anticoagulant, and the INR reflects the effectiveness of anticoagulation therapy. Monitoring the INR helps ensure the client is within the therapeutic range to prevent both clotting and bleeding complications.

2. A client has a new prescription for Furosemide. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypernatremia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Furosemide, a diuretic, commonly causes hyponatremia (low sodium levels) as it increases the excretion of sodium. The nurse needs to monitor the client for signs of hyponatremia, such as confusion, weakness, and muscle cramps, by checking electrolyte levels regularly. Choices A, C, and D are incorrect because hyperkalemia (choice A), hypernatremia (choice C), and hypercalcemia (choice D) are not typically associated with Furosemide use.

3. A client is taking Glipizide to treat Diabetes Mellitus. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of this medication?

• A. Cholesterol level.
• B. Hematocrit.
• C. Blood glucose level.
• D. Calcium level.

Correct answer: C

Rationale: The correct answer is C: Blood glucose level. Monitoring the client's blood glucose level is crucial when taking Glipizide, a medication used to lower blood glucose levels in individuals with Diabetes Mellitus. By monitoring the blood glucose level, the nurse can evaluate the effectiveness of the medication in managing the client's condition. Choices A, B, and D are incorrect as they are not directly related to assessing the effectiveness of Glipizide in treating Diabetes Mellitus. Cholesterol level, hematocrit, and calcium level may be important for other aspects of the client's health but are not the primary indicators of Glipizide's effectiveness.

4. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital has a long half-life of 4 days, meaning it remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should expect to administer phenobarbital once a day to maintain therapeutic levels and effectiveness. Administering it more than once a day would lead to unnecessary dosing and potential adverse effects as the medication remains active in the body for an extended period.

5. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.

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