Nursing Elites

1. During an assessment, a male client who has recently started taking Haloperidol is displaying certain symptoms. Which of the following findings should the nurse prioritize in reporting to the provider?

• A. Shuffling gait
• B. Neck spasms
• C. Drowsiness
• D. Impotence

Correct answer: B

Rationale: Neck spasms are indicative of acute dystonia, a serious side effect of Haloperidol that requires urgent intervention. Immediate reporting to the provider is crucial to address this potentially harmful condition and ensure the client's safety. Shuffling gait, drowsiness, and impotence are important to monitor but do not pose the same level of immediate risk as acute dystonia. Acute dystonia can lead to serious complications if not promptly treated, making it the priority in this scenario.

2. A client has a new prescription for Buspirone to treat Anxiety. Which of the following information should the nurse include?

• A. Take this medication with food.
• B. Expect optimal therapeutic effects within 24 hours.
• C. Take this medication daily for anxiety.
• D. This medication has a low risk for dependency.

Correct answer: D

Rationale: The nurse should educate the client that Buspirone has a low risk for physical or psychological dependence or tolerance. This information is crucial for the client to understand the medication's safety profile and potential risks associated with long-term use.

3. A client is taking Epoetin Alfa for anemia. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. White blood cell count
• B. Platelet count
• C. Hematocrit
• D. Serum potassium level

Correct answer: C

Rationale: The nurse should monitor the hematocrit level to evaluate the effectiveness of Epoetin Alfa therapy. Epoetin Alfa stimulates red blood cell production, leading to an increase in hematocrit levels. Monitoring the hematocrit helps assess the response to therapy and ensures that the medication is effectively addressing the anemia. White blood cell count and platelet count are not directly affected by Epoetin Alfa therapy. Serum potassium level monitoring is important for other medications that may impact potassium levels but is not specifically relevant to assessing the effectiveness of Epoetin Alfa in treating anemia.

4. Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?

• A. Heparin
• B. Alprazolam
• C. Digoxin
• D. Levothyroxine

Correct answer: C

Rationale: Digoxin is the correct answer. It is a medication known for its positive inotropic effects, which increase cardiac output, and negative chronotropic effects, which slow the heart rate. These effects are achieved by inhibiting the sodium-potassium ATPase pump in myocardial cells. Therefore, Digoxin is commonly prescribed to manage conditions like heart failure and atrial fibrillation, where enhancing cardiac output and reducing heart rate are beneficial. Choices A, B, and D are incorrect because Heparin is an anticoagulant, Alprazolam is a benzodiazepine used for anxiety disorders, and Levothyroxine is a thyroid hormone replacement drug, none of which have the specified therapeutic effects on cardiac function.

5. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: The nurse should expect that levothyroxine will be started at a low dose and gradually increased over several weeks. This cautious approach is crucial, especially in older adult clients, to prevent toxicity and ensure optimal therapeutic outcomes for managing hypothyroidism. Choice A is incorrect because starting at a high dose and tapering as needed is not the standard approach for levothyroxine. Choice B is incorrect because the initial dosage is typically adjusted to reach the optimal therapeutic dose. Choice C is incorrect as adjusting the dosage daily based on blood levels is not necessary for levothyroxine, as it has a long half-life and requires time to reach a steady state.

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