Nursing Elites

1. How is lithium typically administered?

• A. Intravenously
• B. Intramuscularly
• C. Orally
• D. Sublingually

Correct answer: C

Rationale: Lithium is typically administered orally to ensure proper absorption and distribution in the body. By taking lithium orally, it allows the medication to be absorbed through the gastrointestinal tract and distributed effectively. Intravenous and intramuscular routes are not commonly used for lithium administration as they can lead to rapid, unpredictable absorption and increase the risk of toxicity. Sublingual administration is also not the typical route for lithium, as it is usually taken orally for consistent and controlled absorption.

2. A client has been prescribed Nitroglycerin patches for angina. Which of the following instructions should the nurse include during discharge teaching?

• A. Apply the patch to a different site each time.
• B. Remove the patch for 12 hours each day.
• C. Apply the patch at the same time every day.
• D. Cut the patch in half if your blood pressure is well controlled.

Correct answer: B

Rationale: The correct answer is B: 'Remove the patch for 12 hours each day.' Nitroglycerin patches should be removed for 12 hours each day to prevent the development of tolerance. This nitrate-free interval ensures the medication remains effective in managing angina. Choice A is incorrect because applying the patch to a different site each time is not necessary; it is more important to ensure a nitrate-free interval. Choice C is incorrect because while consistency in timing is good for medication adherence, the crucial aspect for Nitroglycerin patches is the nitrate-free interval. Choice D is incorrect because cutting the patch in half based on blood pressure control is not a recommended practice and could alter the medication's efficacy.

3. Which of the following is a potassium-sparing diuretic?

• A. Furosemide
• B. Spironolactone
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: B

Rationale: Spironolactone is classified as a potassium-sparing diuretic. It works by antagonizing the aldosterone receptor, leading to potassium retention and sodium excretion. This mechanism makes it a suitable choice for conditions where potassium retention is desired, such as in patients with heart failure or liver cirrhosis. Choices A, C, and D are not potassium-sparing diuretics. Furosemide, hydrochlorothiazide, and bumetanide are loop diuretics and thiazide diuretics, respectively, which promote the excretion of potassium.

4. Which of the following drugs is associated with Stevens-Johnson syndrome?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: D

Rationale: Stevens-Johnson syndrome is a severe skin reaction that can be associated with Ethosuximide.

5. A client is prescribed Propylthiouracil (PTU) for the treatment of Graves' disease. Which adverse effect should the client be instructed to report?

• A. Sore throat.
• B. Drowsiness.
• C. Urinary retention.
• D. Heat intolerance.

Correct answer: A

Rationale: The correct answer is A: Sore throat. A sore throat and fever can indicate agranulocytosis, a serious adverse effect of PTU that can lead to a decreased white blood cell count. This condition requires immediate medical attention to prevent complications. Choice B, drowsiness, is not typically associated with PTU and is not a common adverse effect that needs to be reported. Choice C, urinary retention, is not a typical adverse effect of PTU; therefore, it is not the correct answer. Choice D, heat intolerance, is a symptom commonly seen in hyperthyroidism, which PTU is used to treat, so it is not an adverse effect that needs to be specifically reported.

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