Nursing Elites

1. A healthcare professional is monitoring a client who is receiving spironolactone. Which of the following findings should the professional report to the provider?

• A. Serum Sodium 144 mEq/L
• B. Urine output 120 mL in 4 hours
• C. Serum Potassium 5.2 mEq/L
• D. Blood Pressure 140/90 mm Hg

Correct answer: C

Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia, which is a potentially dangerous condition. Spironolactone, a potassium-sparing diuretic, can cause potassium retention, leading to hyperkalemia. This electrolyte imbalance can result in serious consequences such as cardiac dysrhythmias. The healthcare professional should promptly report this finding to the provider, withhold the medication, and take appropriate actions to prevent complications. Monitoring and managing potassium levels are crucial in clients receiving spironolactone. The other options do not directly relate to the potential adverse effects of spironolactone and are within normal limits, making them less urgent to report.

2. What is the action of Metformin?

• A. Decreasing intestinal glucose absorption
• B. Increasing sensitivity to insulin
• C. Decreasing hepatic glucose production
• D. All of the above

Correct answer: D

Rationale: Metformin exerts its effects by decreasing hepatic glucose production, increasing sensitivity to insulin, and decreasing intestinal glucose absorption. These actions help in lowering blood glucose levels and improving insulin sensitivity in individuals with diabetes.

3. A client has a new prescription for Folic Acid. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Expect a metallic taste in your mouth.
• C. Increase your intake of green, leafy vegetables.
• D. Avoid citrus fruits.

Correct answer: C

Rationale: The correct answer is C: 'Increase your intake of green, leafy vegetables.' Folic acid is naturally found in green, leafy vegetables. By increasing the intake of these vegetables, the client can supplement their folic acid levels. This dietary adjustment supports the client in meeting the prescription requirements and enhances the overall health benefits of folic acid. Choices A, B, and D are incorrect because they do not directly relate to increasing folic acid intake as required by the prescription.

4. A nurse is teaching a client who has a new prescription for Etanercept for Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will need to get my blood drawn periodically while on this medication.'
• B. I should stop taking this medication if I develop a rash.'
• C. I will need to limit my alcohol intake to no more than one drink per week.'
• D. I should self-administer this medication subcutaneously into the muscle.'

Correct answer: A

Rationale: Etanercept can cause bone marrow suppression, so it is important to monitor blood counts regularly.

5. When admitting a client and completing a preassessment before administering medications, which of the following data should the nurse include? (Select all that apply.)

• A. Use of herbal teas
• B. Daily fluid intake
• C. Current health status
• D. Previous surgical history

Correct answer: A

Rationale: The correct answer is A, 'Use of herbal teas.' The nurse should inquire about the client's use of herbal teas because they often contain caffeine, which can impact medication biotransformation. This information is crucial to ensure the safe and effective administration of medications and to prevent potential drug interactions. Choice B, 'Daily fluid intake,' while important for overall assessment, is not directly related to medication administration. Choice C, 'Current health status,' is essential but not specific to medication administration preassessment. Choice D, 'Previous surgical history,' although relevant for a client's medical history, is not directly linked to medication administration preassessment.

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