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 with chronic myeloid leukemia is receiving hydroxyurea. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Hypertension
• C. Neutropenia
• D. Tinnitus

Correct answer: C

Rationale: The nurse should monitor the client for neutropenia when receiving hydroxyurea, as it is a common adverse effect caused by bone marrow suppression. Neutropenia increases the risk of infections, making it crucial for the nurse to closely monitor the client's white blood cell count.

3. A client is starting a new prescription for ferrous sulfate. Which of the following instructions should the nurse include?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Take the medication with orange juice to enhance absorption.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct answer is C: 'Take the medication with orange juice to enhance absorption.' Taking ferrous sulfate with orange juice helps enhance the absorption of iron due to the ascorbic acid present in the orange juice, which aids in iron absorption. This combination can help improve the effectiveness of the medication. Choice A, taking the medication with meals, may reduce gastrointestinal side effects but does not specifically enhance absorption. Choice B, taking the medication on an empty stomach, may lead to better absorption but can also increase the risk of gastrointestinal side effects. Choice D, taking the medication with a full glass of milk, is incorrect because calcium in milk can inhibit the absorption of iron.

4. A client has a prescription for Amoxicillin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Avoid taking the medication with milk.
• C. Expect your stools to turn clay-colored.
• D. Complete the entire course of therapy.

Correct answer: D

Rationale: The correct answer is D: Complete the entire course of therapy. It is crucial for clients to complete the entire course of amoxicillin therapy to ensure the infection is fully treated and to prevent antibiotic resistance. Prematurely stopping the antibiotic can lead to incomplete eradication of the infection, potentially causing it to return and be more difficult to treat. Choices A and B are not specific to amoxicillin and are general medication administration instructions. Choice C is not a common side effect of amoxicillin and does not require patient education.

5. A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?

• A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
• B. Leucovorin increases platelet production and prevents bleeding.
• C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
• D. Leucovorin protects healthy cells from Methotrexate's toxic effects.

Correct answer: D

Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment. Choices A, B, and C are incorrect because Leucovorin does not reduce the risk of a transfusion reaction from Methotrexate, increase platelet production, prevent bleeding, or potentiate the cytotoxic effects of Methotrexate. Instead, Leucovorin works by rescuing healthy cells from the toxic effects of Methotrexate.

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