Nursing Elites

1. The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client?

• A. Paralytic ileus
• B. Incisional pain
• C. Urinary retention
• D. Nausea and vomiting

Correct answer: D

Rationale: Ondansetron, also known as Zofran, is an antiemetic medication primarily used to treat nausea and vomiting. In the postoperative setting, it is commonly administered to manage postoperative nausea and vomiting, which are frequent occurrences after surgery. Ondansetron works by blocking serotonin, a natural substance in the body that can trigger nausea and vomiting. It is also utilized to manage chemotherapy-induced nausea and vomiting. Therefore, the correct condition for which ondansetron should be administered to the postoperative client is nausea and vomiting.

2. A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?

• A. Lung sounds
• B. Blood pressure
• C. Blood ammonia level
• D. Serum potassium level

Correct answer: C

Rationale: In portosystemic encephalopathy, the liver's ability to detoxify ammonia is impaired, leading to elevated blood ammonia levels, which can cause neurological symptoms such as encephalopathy. Lactulose is given to reduce ammonia levels by promoting its excretion through the bowel. Therefore, assessing the blood ammonia level is crucial to determine the effectiveness of lactulose therapy in managing portosystemic encephalopathy.

3. A client with hypertension is prescribed lisinopril (Zestril). Which instruction should the nurse include in the teaching plan?

• A. Avoid foods high in potassium.
• B. Avoid taking the medication with grapefruit juice.
• C. Monitor blood pressure regularly.
• D. Report any swelling of the lips or face.

Correct answer: D

Rationale: The correct instruction for the nurse to include in the teaching plan is to 'Report any swelling of the lips or face.' Lisinopril (Zestril) can cause angioedema, which is swelling of the lips or face. This is a serious side effect that should be reported immediately. Clients do not need to avoid potassium-rich foods unless instructed by their healthcare provider, should avoid taking the medication with grapefruit juice, and should monitor their blood pressure regularly, not just weekly.

4. A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that which of the following indicates toxicity associated with the medication?

• A. Sodium of 140 mEq/L
• B. Prothrombin time of 12 seconds
• C. Platelet count of 400,000 cells/mm³
• D. A direct bilirubin level of 2 mg/dL

Correct answer: D

Rationale: A direct bilirubin level of 2 mg/dL indicates liver damage, which can be caused by an overdose of acetaminophen. Acetaminophen toxicity can lead to liver injury, manifesting as elevated bilirubin levels and other liver function test abnormalities.

5. A client with hyperlipidemia is prescribed atorvastatin (Lipitor). Which instruction should the nurse include in the teaching plan?

• A. Take the medication in the morning.
• B. Avoid consuming grapefruit juice.
• C. Increase your intake of dairy products.
• D. Take the medication with food.

Correct answer: B

Rationale: The correct instruction for the nurse to include in the teaching plan is to advise the client to avoid consuming grapefruit juice. Grapefruit juice can increase the risk of atorvastatin (Lipitor) toxicity by inhibiting its metabolism. Atorvastatin is typically taken in the evening as cholesterol synthesis occurs at night. Increasing dairy intake is not specifically recommended for atorvastatin therapy, and the medication can be taken with or without food.

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