Nursing Elites

1. While assessing a client taking Amiodarone to treat Atrial Fibrillation, which of the following findings is indicative of Amiodarone toxicity?

• A. Light yellow urine
• B. Report of tinnitus
• C. Productive cough
• D. Blue-gray skin discoloration

Correct answer: C

Rationale: Productive cough can indicate pulmonary toxicity, which is a known adverse effect of Amiodarone. Clients on Amiodarone should be monitored for signs of pulmonary toxicity such as cough, dyspnea, and chest pain. This is important to detect early and prevent serious complications. The other options are not typically associated with Amiodarone toxicity. Light yellow urine is not a common sign, tinnitus is more related to ear problems, and blue-gray skin discoloration is not a recognized symptom of Amiodarone toxicity.

2. A healthcare professional is monitoring a client who is receiving spironolactone. Which of the following findings should the professional report to the provider?

• A. Serum Sodium 144 mEq/L
• B. Urine output 120 mL in 4 hours
• C. Serum Potassium 5.2 mEq/L
• D. Blood Pressure 140/90 mm Hg

Correct answer: C

Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia, which is a potentially dangerous condition. Spironolactone, a potassium-sparing diuretic, can cause potassium retention, leading to hyperkalemia. This electrolyte imbalance can result in serious consequences such as cardiac dysrhythmias. The healthcare professional should promptly report this finding to the provider, withhold the medication, and take appropriate actions to prevent complications. Monitoring and managing potassium levels are crucial in clients receiving spironolactone. The other options do not directly relate to the potential adverse effects of spironolactone and are within normal limits, making them less urgent to report.

3. A client is admitted for a surgical procedure. Which preexisting condition can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine can produce psychological effects like hallucinations. Patients with schizophrenia may be more prone to experiencing exacerbation of their symptoms when exposed to Ketamine due to its potential to worsen psychotic symptoms. Therefore, schizophrenia can be a contraindication for the use of Ketamine as an anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for the use of Ketamine.

4. A client with a new prescription for Verapamil to control hypertension is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?

• A. I should avoid drinking grapefruit juice.
• B. I can expect my heart rate to increase while taking this medication.
• C. This medication will cause my urine to turn orange.
• D. I will stop taking this medication if I experience headaches.

Correct answer: A

Rationale: The correct answer is A. Grapefruit juice can increase blood levels of verapamil, leading to increased effects and potentially serious side effects such as hypotension or bradycardia. It is crucial for the client to avoid grapefruit juice while taking Verapamil to prevent these adverse reactions. Choice B is incorrect because verapamil is a calcium channel blocker that typically lowers heart rate. Choice C is incorrect as verapamil does not cause urine discoloration. Choice D is incorrect because stopping medication abruptly without consulting a healthcare provider can be dangerous.

5. A client is receiving treatment with capecitabine. Which of the following findings should the nurse monitor?

• A. Hyperglycemia
• B. Hypocalcemia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: The nurse should monitor the client for neutropenia when receiving capecitabine, as it is a common adverse effect caused by bone marrow suppression. Neutropenia increases the risk of infection, making it essential for the nurse to closely monitor the client's white blood cell count and assess for signs of infection during treatment. Hyperglycemia (Choice A) is not typically associated with capecitabine. Hypocalcemia (Choice B) and bradycardia (Choice D) are not commonly linked to capecitabine use. Therefore, monitoring for neutropenia is the priority in this scenario.

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