Nursing Elites

1. A healthcare professional is educating a client about the adverse effects of Metformin. Which of the following adverse effects should the healthcare professional include?

• A. Lactic acidosis.
• B. Hypoglycemia.
• C. Hyperlipidemia.
• D. Weight gain.

Correct answer: A

Rationale: The correct answer is A: Lactic acidosis. Lactic acidosis is a rare but severe side effect of Metformin, particularly in individuals with renal or liver issues. It is crucial for clients taking Metformin to be aware of the symptoms of lactic acidosis, such as muscle pain, weakness, trouble breathing, stomach discomfort, and feeling cold. Choice B, hypoglycemia, is not a common adverse effect of Metformin but can occur when combined with other antidiabetic medications. Choice C, hyperlipidemia, is not a typical adverse effect of Metformin. Choice D, weight gain, is not associated with Metformin use; in fact, Metformin is often associated with weight loss or weight neutrality.

2. Which of the following is classified as a class IA Sodium Channel blocker?

• A. Quinidine
• B. Disopyramide
• C. Aminodarone
• D. Propafenone

Correct answer: A

Rationale: Quinidine is classified as a class IA sodium channel blocker. Class IA antiarrhythmics, like quinidine, work by blocking sodium channels and delaying repolarization. Propafenone, mentioned in the original rationale, is actually a class IC antiarrhythmic agent, not a class IA sodium channel blocker.

3. A patient is receiving spironolactone for heart failure. Which of the following findings should the nurse report to the provider?

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

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia due to its mechanism of action. Hyperkalemia, or elevated potassium levels, can result in serious cardiac complications and requires immediate medical attention. Therefore, the nurse should promptly report any signs or symptoms of hyperkalemia to prevent potential adverse outcomes in the patient. Choices B, C, and D are incorrect because spironolactone is not associated with hypernatremia, hyponatremia, or hypokalemia. Hyperkalemia is the critical finding that the nurse should report in a patient receiving spironolactone.

4. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

5. A client in the emergency department has Benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority?

• A. Administer flumazenil.
• B. Identify the client's level of orientation.
• C. Infuse IV fluids.
• D. Prepare the client for gastric lavage.

Correct answer: B

Rationale: In a situation where a client presents with Benzodiazepine toxicity, the priority action for the nurse is to assess the client. By identifying the client's level of orientation, the nurse can gather crucial information about the client's mental status, which is essential for determining the appropriate care and interventions needed. Administering flumazenil is used to reverse the effects of benzodiazepines but should be based on a comprehensive assessment. Infusing IV fluids and preparing for gastric lavage may be necessary interventions but should follow a thorough assessment of the client's condition to ensure proper prioritization of care.

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