Nursing Elites

1. A nurse is reviewing the medication class benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients?

• A. A client with glaucoma
• B. A client with renal failure
• C. A client with hypertension
• D. A client with insomnia

Correct answer: A

Rationale: The correct answer is A. Benzodiazepines should be used cautiously in clients with glaucoma because these medications can increase intraocular pressure. Choices B, C, and D are incorrect because renal failure, hypertension, and insomnia are not contraindications for administering benzodiazepines.

2. A nurse is reviewing the medical record of a client who is prescribed acetaminophen for pain. Which of the following lab values should the nurse monitor to identify an adverse effect of the medication?

• A. Serum glucose
• B. Serum creatinine
• C. Serum potassium
• D. Serum bilirubin

Correct answer: B

Rationale: The correct answer is B: Serum creatinine. Acetaminophen is metabolized by the liver, so serum creatinine levels should be monitored for potential hepatotoxicity. Monitoring serum creatinine can help detect liver damage, a potential adverse effect of acetaminophen. Choices A, C, and D are incorrect because serum glucose is not directly affected by acetaminophen, serum potassium is not typically monitored for acetaminophen adverse effects, and serum bilirubin is more related to bile metabolism rather than acetaminophen-induced hepatotoxicity.

3. A nurse is preparing to administer nitroglycerin ointment to a client. Which of the following actions should the nurse take?

• A. Apply the ointment to the client's hairless chest
• B. Rub the ointment gently into the skin
• C. Cover the applied ointment with a transparent dressing
• D. Massage the ointment into the skin

Correct answer: A

Rationale: The correct action is to apply the nitroglycerin ointment to a hairless area of the client's chest, back, or upper arms. This allows for better absorption of the medication. Choice B is incorrect because rubbing the ointment gently into the skin may be appropriate, but the primary action is to ensure application on a hairless area. Choice C is incorrect as covering the ointment with a transparent dressing is not a standard practice for nitroglycerin ointment administration. Choice D is incorrect because massaging the ointment into the skin is not recommended, as it can alter absorption rates.

4. 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.

5. A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism?

• A. Scleroderma
• B. Osteoporosis
• C. Asthma
• D. Peripheral Vascular Disease

Correct answer: B

Rationale: The correct answer is B: Osteoporosis. Osteoporosis is a concern with levothyroxine as it can increase the risk for fractures, particularly in older adults. Levothyroxine treatment can exacerbate bone loss in individuals with osteoporosis. Choices A, C, and D are not directly contraindicated with levothyroxine therapy for hypothyroidism.

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