Nursing Elites

1. A client has a new prescription for Prednisone. Which of the following laboratory values should the nurse monitor?

• A. Serum potassium
• B. Serum calcium
• C. Serum sodium
• D. Serum glucose

Correct answer: D

Rationale: The correct answer is D, Serum glucose. Prednisone is a corticosteroid that can lead to hyperglycemia. Monitoring serum glucose levels is essential to assess for elevated blood sugar levels. Choices A, B, and C are incorrect as Prednisone does not directly affect potassium, calcium, or sodium levels.

2. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client monitor for and report to the provider?

• A. Dry cough
• B. Pedal edema
• C. Bruising
• D. Yellow-tinged vision

Correct answer: D

Rationale: The correct answer is D: Yellow-tinged vision. Yellow-tinged vision is a potential adverse effect of Digoxin and may indicate toxicity. Clients should be instructed to report this symptom promptly to the healthcare provider to prevent complications. Dry cough (choice A) is not typically associated with Digoxin. Pedal edema (choice B) is more commonly seen with heart failure but is not a direct adverse effect of Digoxin. Bruising (choice C) is not a common adverse effect of Digoxin.

3. A client has ordered a thrombolytic medication for the treatment of CVA. Which type of stroke should not be treated with a thrombolytic?

• A. Hemorrhagic stroke
• B. Thrombotic stroke
• C. Both types can be treated with a thrombolytic
• D. Neither type can be treated with a thrombolytic

Correct answer: A

Rationale: Thrombolytic medications are used to dissolve blood clots. In the case of a hemorrhagic stroke, where there is bleeding in the brain, the use of thrombolytics can worsen the condition by increasing bleeding. Therefore, hemorrhagic strokes should not be treated with thrombolytic medications.

4. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)

• A. Thrombocyte count.
• B. Hematocrit.
• C. Amylase.
• D. Liver function tests.

Correct answer: A

Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.

5. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

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