Nursing Elites

1. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.

2. A client has a new prescription for Bisacodyl. Which of the following statements should the nurse include?

• A. Take the medication before bedtime.
• B. Expect a rapid heart rate.
• C. Increase your intake of high-sodium foods.
• D. Expect rectal burning with the suppository form.

Correct answer: D

Rationale: The correct statement to include when educating a client about Bisacodyl is to expect rectal burning with the suppository form. Bisacodyl, a stimulant laxative, is known to cause rectal burning when administered as a suppository. This side effect is common and expected, and it is important for the client to be aware of it to prevent unnecessary alarm or concern. Choices A, B, and C are incorrect. Taking Bisacodyl before bedtime is not a common instruction; expecting a rapid heart rate is not a typical side effect of Bisacodyl; and increasing intake of high-sodium foods is not related to the use of Bisacodyl.

3. A client has a new prescription for Metformin to treat type 2 diabetes. Which of the following laboratory results should be monitored?

• A. Hemoglobin A1C
• B. Liver function tests
• C. Electrolyte levels
• D. Kidney function

Correct answer: D

Rationale: Metformin is excreted by the kidneys, and impaired kidney function can lead to an increased risk of lactic acidosis, a serious side effect. Therefore, it is important to monitor kidney function regularly while a client is on Metformin. Hemoglobin A1C is used to monitor long-term glucose control, but kidney function is the priority for monitoring Metformin therapy.

4. A healthcare provider is assessing a client who is taking Digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity?

• A. Bruising
• B. Report of metallic taste
• C. Muscle pain
• D. Report of anorexia

Correct answer: D

Rationale: The correct manifestation of digoxin toxicity is the report of anorexia. Anorexia, blurred vision, stomach pain, and diarrhea are common signs of digoxin toxicity. Bruising, metallic taste, and muscle pain are not typically associated with digoxin toxicity. Patients should promptly report symptoms of toxicity to their healthcare provider for further evaluation and management.

5. When educating a client with a new prescription for Amlodipine, which instruction should the nurse provide?

• A. Increase your intake of dairy products.
• B. Avoid driving until you see how the medication affects you.
• C. Stop taking the medication if you develop a dry cough.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid driving until they understand the medication's effects. Amlodipine can cause dizziness, making it unsafe to drive until the client knows how the medication affects them. This instruction promotes client safety and prevents potential accidents due to medication side effects.

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