Nursing Elites

1. A client has a new prescription for Warfarin. Which of the following herbal supplements should the client be instructed to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by affecting its metabolism. Echinacea, garlic, and ginseng are also known to interact with Warfarin, either by increasing the risk of bleeding or altering its anticoagulant effects. However, St. John's wort is particularly significant due to its potent enzyme-inducing properties that can lead to subtherapeutic levels of Warfarin, potentially increasing the risk of blood clots.

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 client has 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 instruction for a client prescribed Lisinopril is to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, hence the importance of avoiding salt substitutes that may contain potassium. Instructing the client to avoid salt substitutes helps prevent potential adverse effects of increased potassium levels.

4. A client is being assessed by a healthcare provider while taking Digoxin to manage 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 anorexia, not bruising, metallic taste, or muscle pain. Other symptoms of digoxin toxicity include blurred vision, stomach pain, and diarrhea. It is crucial for healthcare providers to promptly identify these signs to prevent severe complications.

5. A client has a prescription for gentamicin for the treatment of an infection. Which finding indicates a potential adverse reaction to the medication?

• A. Blood pressure 160/90 mm Hg
• B. Presence of red blood cells in the urine
• C. Urine output of 35 mL/hr
• D. Respiratory rate of 22/min

Correct answer: B

Rationale: The presence of red blood cells in the urine can indicate nephrotoxicity, which is a potential adverse effect of gentamicin. Gentamicin can cause damage to the kidneys, leading to the presence of red blood cells in the urine as a sign of renal impairment. Monitoring for this finding is crucial to detect and manage adverse reactions promptly. High blood pressure (Choice A) is not typically associated with gentamicin use. Low urine output (Choice C) is more suggestive of kidney injury rather than nephrotoxicity specifically related to gentamicin. Respiratory rate (Choice D) is not a common indicator of adverse reactions to gentamicin.

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