Nursing Elites

1. A client with heart failure is being instructed on laxative use. Which of the following laxatives should the client avoid?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: The correct answer is A: Sodium phosphate. Clients with heart failure often follow a sodium-restricted diet. Sodium phosphate laxatives can lead to sodium absorption, causing fluid retention, which is contraindicated in heart failure. It is crucial to avoid sodium phosphate laxatives in these clients to prevent exacerbation of fluid overload and heart failure symptoms. Psyllium (choice B), Bisacodyl (choice C), and Polyethylene glycol (choice D) are not contraindicated in clients with heart failure and can be used safely for bowel management.

2. Before administering lithium to a client with bipolar disorder who has been taking the medication for 1 year, the nurse should check to see that which of the following tests has been completed?

• A. Thyroid hormone assay
• B. Liver function tests
• C. Erythrocyte sedimentation rate
• D. Brain natriuretic peptide

Correct answer: A

Rationale: The correct answer is to check the thyroid hormone assay. Long-term lithium use can result in thyroid dysfunction, making it crucial to monitor the client's thyroid function regularly to detect any abnormalities early and prevent potential complications. Liver function tests (choice B) are not specifically associated with lithium therapy. Erythrocyte sedimentation rate (choice C) is a nonspecific test for inflammation and not directly related to lithium therapy. Brain natriuretic peptide (choice D) is a test used to diagnose heart failure and is not relevant to monitoring lithium therapy.

3. A healthcare professional is caring for an older adult client who has a new prescription for Digoxin and takes multiple other medications. Which of the following medications, when used concurrently with Digoxin, places the client at risk for Digoxin toxicity?

• A. Phenytoin
• B. Verapamil
• C. Warfarin
• D. Aluminum hydroxide

Correct answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to Digoxin toxicity. When these medications are used together, the client is at an increased risk. Phenytoin (Choice A) does not significantly impact digoxin levels. Warfarin (Choice C) and aluminum hydroxide (Choice D) do not directly increase the risk of Digoxin toxicity. Therefore, the correct choice is Verapamil (Choice B) due to its potential to raise digoxin levels and cause toxicity.

4. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital has a long half-life of 4 days, meaning it remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should expect to administer phenobarbital once a day to maintain therapeutic levels and effectiveness. Administering it more than once a day would lead to unnecessary dosing and potential adverse effects as the medication remains active in the body for an extended period.

5. A client has a new prescription for Allopurinol. Which of the following instructions should be included by the healthcare provider?

• 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 increase the risk of kidney stones as a side effect. To prevent this adverse effect, it is essential for the client to increase their fluid intake. Adequate hydration can help in preventing the formation of kidney stones by keeping urine dilute and flushing out substances that can lead to stone formation.

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