Nursing Elites

1. When providing discharge instructions to a client with a new prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it is essential to avoid salt substitutes containing potassium, which can further increase potassium levels in the body. This instruction aims to prevent potential adverse effects and ensure the client's safety while taking Lisinopril. Choices B, C, and D are incorrect because Lisinopril is typically taken once a day in the morning, it can lead to hyperkalemia (so increasing potassium-rich foods is not advised), and it can be taken with or without food.

2. What is pharmacodynamics?

• A. The medical reference summarizing standards of drug purity, strength, and directions for synthesis
• B. The drug's actions at receptor sites and the physiological, chemical, and behavioral effects produced by these actions
• C. The maximum response that a drug can produce
• D. Movements of the drugs throughout the body

Correct answer: B

Rationale: Pharmacodynamics refers to the drug's actions at receptor sites and the physiological, chemical, and behavioral effects produced by these actions. It involves understanding how drugs interact with the body at the molecular level to produce their effects, including mechanisms of action, receptor binding, and downstream physiological responses. Choice A is incorrect because it describes pharmacopeia, which is a reference book containing standards for drugs. Choice C refers to efficacy, which is the maximum effect a drug can produce. Choice D describes pharmacokinetics, which focuses on the movement of drugs within the body.

3. A client is receiving discharge teaching for a new prescription of Fluoxetine for PTSD. Which of the following statements should be included in the teaching?

• A. You may experience a decreased desire for intimacy while taking this medication.
• B. You should take this medication in the evening to help promote sleep.
• C. You may experience fewer urinary adverse effects if you urinate just before taking this medication.
• D. You should wear sunglasses when outdoors due to the light sensitivity caused by this medication.

Correct answer: A

Rationale: One of the potential adverse effects of fluoxetine and other SSRIs is a decreased libido, which can impact intimacy. It is essential for the nurse to educate the client about this possible side effect to promote awareness and understanding of the medication's effects.

4. A client has a new prescription for Allopurinol. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your fluid intake.
• C. Avoid foods high in calcium.
• D. Take this medication with meals.

Correct answer: B

Rationale: Allopurinol can cause kidney stones due to the formation of uric acid crystals, so it is crucial for the client to increase their fluid intake. Adequate hydration helps to prevent the formation of kidney stones by diluting the urine and promoting the excretion of uric acid. Therefore, advising the client to increase their fluid intake is essential in preventing this adverse effect while taking Allopurinol.

5. A healthcare professional is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the healthcare professional?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: Performing immediate gastric lavage is the appropriate action for a client with severe lithium toxicity, indicated by a plasma lithium level of 2.1 mEq/L. Gastric lavage can help reduce the client's lithium level by removing the unabsorbed drug from the stomach.

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