Nursing Elites

1. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

2. A healthcare professional is preparing to administer IV Dantrolene to a client who has developed Malignant Hyperthermia during surgery. Which of the following actions should the healthcare professional take?

• A. Dilute the medication with sterile water and administer it rapidly.
• B. Store the medication in a refrigerator until use.
• C. Administer the medication through a large-bore IV catheter.
• D. Administer the medication via an infusion pump over 60 minutes.

Correct answer: C

Rationale: Dantrolene should be administered through a large-bore IV catheter because it is highly irritating to tissues and can cause vein irritation or thrombophlebitis if administered through a small vein. Using a large-bore IV catheter helps to minimize the risk of tissue damage and ensures proper and safe administration of the medication in emergency situations like Malignant Hyperthermia. Choices A, B, and D are incorrect because diluting the medication with sterile water and administering it rapidly can lead to tissue damage, storing the medication in a refrigerator is not necessary, and administering the medication via an infusion pump over 60 minutes is not appropriate in emergency situations like Malignant Hyperthermia where rapid administration is crucial.

3. A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should NOT be used with caution in combination with which drug classes?

• A. NSAIDs
• B. Cardiac glycosides
• C. Beta blockers
• D. None of the above

Correct answer: C

Rationale: Calcium channel blockers and beta blockers should be used with caution together because they can both suppress heart function, potentially leading to bradycardia, heart block, or heart failure. NSAIDs and cardiac glycosides do not have significant interactions with calcium channel blockers in the same way, so they are not typically a cause for concern when combined.

4. Which of the following is not a side effect of the ACE Inhibitor (Captopril)?

• A. Rash
• B. Angioedema
• C. Cough
• D. Congestion

Correct answer: D

Rationale: Congestion is not a common side effect associated with ACE inhibitors such as Captopril. ACE inhibitors are known to cause a dry, persistent cough due to bradykinin accumulation, rash, and angioedema, but congestion is not typically listed as a side effect.

5. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following over-the-counter medications should the provider instruct the client to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. The combination of Warfarin, an anticoagulant, and NSAIDs can potentiate the risk of bleeding complications. Clients on Warfarin should avoid NSAIDs like ibuprofen and opt for alternative pain relief options such as acetaminophen. Diphenhydramine and loratadine are antihistamines and are generally safe to use with Warfarin as they do not significantly increase the risk of bleeding when compared to NSAIDs like ibuprofen.

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