Nursing Elites

1. When assessing a client taking Lithium Carbonate for Bipolar disorder, which finding should the nurse recognize as a possible indication of toxicity to this medication?

• A. Severe hypertension
• B. Coarse tremors
• C. Constipation
• D. Muscle spasm

Correct answer: B

Rationale: The correct answer is B: Coarse tremors. Coarse tremors are a common sign of Lithium toxicity. Monitoring for tremors is crucial as they can indicate a potentially serious complication that requires immediate intervention. While other options such as severe hypertension, constipation, and muscle spasm may be symptoms of various conditions, they are not typically associated with Lithium toxicity. Severe hypertension is not a common sign of Lithium toxicity; constipation is not a typical symptom of Lithium toxicity either, and muscle spasm is not a direct indicator of Lithium toxicity.

2. A client has a new prescription for clonidine to treat hypertension. Which of the following instructions should the nurse include?

• A. Discontinue the medication if a rash develops.
• B. Expect increased salivation during the first few weeks of therapy.
• C. Avoid driving until the client's reaction to the medication is known.
• D. Stop the medication if you experience a dry mouth.

Correct answer: C

Rationale: The correct instruction for a client starting clonidine therapy for hypertension is to avoid driving until their reaction to the medication is known. Clonidine can cause drowsiness, so engaging in activities like driving that require alertness should be avoided until the individual understands how the medication affects them. Choices A, B, and D are incorrect because they do not address the specific side effect of drowsiness associated with clonidine that could impair driving abilities. Discontinuing the medication if a rash develops, expecting increased salivation, or stopping the medication for dry mouth are not primary concerns related to clonidine therapy for hypertension.

3. A client asks a nurse about Feverfew. Which response should the nurse provide?

• A. It is used to treat skin infections.
• B. It can decrease the frequency of migraine headaches.
• C. It can lessen the nasal congestion in the common cold.
• D. It can relieve nausea of morning sickness during pregnancy.

Correct answer: B

Rationale: The correct response is B: 'It can decrease the frequency of migraine headaches.' Feverfew is known for reducing the frequency of migraine headaches, but it has not been proven to relieve an existing migraine headache. Choices A, C, and D are incorrect because Feverfew is not used to treat skin infections, lessen nasal congestion in the common cold, or relieve nausea of morning sickness during pregnancy.

4. A client has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?

• A. Take the medication with food.
• B. Plan to take the medication at bedtime.
• C. Expect increased swelling of the ankles.
• D. Limit fluid intake in the morning.

Correct answer: A

Rationale: When educating a client about taking Hydrochlorothiazide, the nurse should advise taking the medication with food or after meals to prevent gastrointestinal upset. This medication is a diuretic, so it is important to maintain adequate fluid intake throughout the day to prevent dehydration. Taking it at bedtime is not necessary, and increased swelling of the ankles is not an expected side effect of this medication. Limiting fluid intake in the morning is not necessary and could lead to dehydration, which is a potential side effect of this diuretic.

5. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

• A. This medication can safely be taken during pregnancy.
• B. Eliminate grapefruit juice from your diet.
• C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
• D. Notify your provider if you develop a rash.

Correct answer: B

Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.

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