Nursing Elites

1. What is the expected outcome of Valproate therapy?

• A. Decreased fever
• B. Decreased sense of anxiety
• C. Decreased blood pressure
• D. Decreased seizure activity

Correct answer: D

Rationale: The correct answer is D: Decreased seizure activity. Valproate is commonly used in the treatment of epilepsy to help control and reduce seizure frequency. Choices A, B, and C are incorrect because Valproate is not primarily used to treat fever, anxiety, or blood pressure issues.

2. A healthcare professional is reviewing the laboratory results of a client who is taking Lithium for Bipolar Disorder. Which of the following findings should the healthcare professional report to the provider immediately?

• A. Lithium level of 1.0 mEq/L
• B. Potassium level of 3.5 mEq/L
• C. Sodium level of 140 mEq/L
• D. Creatinine level of 1.0 mg/dL

Correct answer: D

Rationale: A creatinine level of 1.0 mg/dL should be reported to the provider immediately. While a lithium level of 1.0 mEq/L falls within the therapeutic range, a creatinine level of 1.0 mg/dL could suggest early signs of kidney dysfunction, especially concerning in a client on long-term lithium therapy. It is crucial to monitor kidney function closely because lithium can be nephrotoxic over time. Elevated creatinine levels may indicate impaired kidney function and should prompt immediate reporting to the healthcare provider. Potassium and sodium levels within normal range are not immediate concerns when compared to potential kidney issues.

3. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.

4. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain is not relieved after 5 minutes, the client should call 911 and take a second tablet. Taking more than the recommended dose can lead to serious side effects, and swallowing the tablet would not provide the rapid effect needed in cases of chest pain. Choice A is correct because it aligns with the standard protocol for nitroglycerin use in treating angina. Choice B is incorrect as the second tablet should be taken after 5 minutes, not 10 minutes. Choice C is incorrect as taking up to five tablets in 15 minutes is excessive and can result in serious complications. Choice D is incorrect as nitroglycerin sublingual tablets should be placed under the tongue for rapid absorption, not swallowed.

5. When should a patient taking omeprazole be administered the medication?

• A. Before bedtime
• B. After dinner
• C. In the morning on an empty stomach
• D. With the patient's lunch meal

Correct answer: C

Rationale: Omeprazole should be administered in the morning on an empty stomach to maximize its effectiveness. This timing is important as omeprazole works best when taken before a meal to inhibit acid production by the stomach. Taking it on an empty stomach in the morning allows the medication to be absorbed efficiently and provides optimal therapeutic effects throughout the day. Choices A, B, and D are incorrect because taking omeprazole before bedtime, after dinner, or with lunch may not allow the medication to work effectively as it requires an empty stomach for better absorption and action.

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