Nursing Elites

1. 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.

2. A healthcare provider in a clinic is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?

• A. Calcium 9.2 mg/dL
• B. Calcium 10.3 mg/dL
• C. Potassium 3.4 mEq/L
• D. Potassium 4.8 mEq/L

Correct answer: C

Rationale: Potassium 3.4 mEq/L is below the expected reference range, which increases the risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, particularly in older clients taking Digoxin. Hypokalemia potentiates the effects of Digoxin, making the heart more sensitive to its toxic effects. Monitoring and correcting electrolyte imbalances, especially low potassium levels, are crucial to prevent adverse effects of digoxin therapy. Calcium levels do not directly influence digoxin toxicity, so choices A and B are incorrect. High potassium levels, as in choice D, are less likely to increase the risk of digoxin toxicity compared to low potassium levels.

3. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?

• A. Increase your intake of high-fiber foods.
• B. Take the medication with grapefruit juice.
• C. Expect to feel drowsy or lightheaded.
• D. Avoid dairy products while taking this medication.

Correct answer: A

Rationale: The correct instruction to include when a client is prescribed Verapamil is to increase their intake of high-fiber foods. Verapamil can cause constipation as a side effect, and increasing fiber intake can help prevent constipation. High-fiber foods promote bowel regularity and can counteract the constipating effects of Verapamil. Choices B, C, and D are incorrect because taking Verapamil with grapefruit juice can lead to adverse reactions, drowsiness or lightheadedness is not a typical side effect of Verapamil, and there is no need to avoid dairy products specifically while taking this medication.

4. A client has a new prescription for Amlodipine. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication at bedtime.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of high-sodium foods.
• D. Expect a dry cough.

Correct answer: B

Rationale: The correct instruction for the nurse to include during discharge teaching is to advise the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of amlodipine, a calcium channel blocker, leading to increased drug levels in the blood. This can result in potentiated side effects and potential toxicity. Option A is incorrect as amlodipine is usually taken once daily, not specifically at bedtime. Option C is incorrect because high-sodium foods are generally discouraged in individuals with hypertension. Option D is incorrect as a dry cough is not an expected side effect of amlodipine.

5. A client has a new prescription for Calcitonin-salmon for Osteoporosis. Which of the following tests should the client expect before beginning this medication?

• A. Skin test for allergy to the medication
• B. ECG to rule out cardiac dysrhythmias
• C. Mantoux test to rule out exposure to tuberculosis
• D. Liver function tests to assess risk for medication toxicity

Correct answer: A

Rationale: Before initiating Calcitonin-salmon, a skin test for allergy to the medication may be performed to prevent anaphylactic reactions. Allergic reactions can occur due to sensitivities to the drug, particularly in individuals with fish allergies. Therefore, it is essential for healthcare providers to assess the client's potential allergic response to Calcitonin-salmon through a skin test. The other options are not relevant in this context. An ECG is not typically required before starting Calcitonin-salmon for Osteoporosis, nor is a Mantoux test or liver function tests.

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