Nursing Elites

1. A healthcare professional reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the professional take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication, and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify trough levels of a medication, the healthcare professional should obtain a blood specimen immediately before administering the next dose of medication. This timing ensures an accurate representation of the medication's lowest concentration in the bloodstream, which is crucial for therapeutic monitoring and dose adjustments. Choice B is incorrect because waiting 24 hours after taking the medication would not provide an accurate trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect because obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level, as it is the lowest concentration before the next dose.

2. A client has a new prescription for Somatropin to stimulate growth. The client should monitor for which of the following adverse effects?

• A. Hyperglycemia.
• B. Bradycardia.
• C. Urinary frequency.
• D. Edema.

Correct answer: A

Rationale: Somatropin is known to cause hyperglycemia as a common adverse effect. Therefore, the client should be instructed to monitor for elevated blood glucose levels closely while taking this medication to ensure early detection and management of hyperglycemia.

3. Which of the following is the antidote for Heparin toxicity?

• A. Protamine
• B. Methylene blue
• C. N-acetylcysteine
• D. Glucagon

Correct answer: A

Rationale: Protamine is the specific antidote for Heparin toxicity. Heparin is an anticoagulant medication, and if an overdose occurs or if there is excessive bleeding due to Heparin use, protamine, a positively charged molecule, can neutralize the anticoagulant effects of Heparin by forming a complex with it. This binding prevents Heparin from further inhibiting coagulation factors and helps in reversing its effects.

4. A client has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide?

• A. Take the medication on an empty stomach to decrease gastrointestinal irritation.
• B. Take the medication with orange juice to enhance absorption.
• C. Take the medication with milk.
• D. Rinse the mouth before taking the iron.

Correct answer: B

Rationale: Taking ferrous sulfate with orange juice can help increase the absorption of iron. Orange juice contains vitamin C, which aids in the absorption of iron from the medication. This combination can enhance the effectiveness of the iron supplement for a client with anemia. Option A is incorrect because taking iron on an empty stomach can cause gastrointestinal upset. Option C is incorrect because calcium in milk can inhibit iron absorption. Option D is irrelevant to enhancing iron absorption.

5. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients who develop tachycardia, such as in the case of reflex tachycardia induced by Isosorbide Mononitrate, making it the appropriate choice in this scenario. Furosemide (Choice A) is a loop diuretic used for conditions like heart failure and edema, not for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor primarily used for hypertension and heart failure, not for reflex tachycardia. Ranolazine (Choice C) is used for chronic angina but does not specifically address reflex tachycardia.

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