Nursing Elites

1. A client with a diagnosis of bipolar disorder is prescribed lamotrigine. The nurse should monitor for which potential adverse effect?

• A. Rash
• B. Tremors
• C. Hair loss
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Rash. Lamotrigine can cause a rash, which may indicate a serious adverse effect like Stevens-Johnson syndrome. Monitoring for a rash is crucial in clients taking lamotrigine to promptly address any potential severe reactions.

2. Which assessment finding requires nursing intervention prior to the administration of medication?

• A. Apical pulse heard best at the pulmonic site
• B. Irregular apical pulse rhythm
• C. Presence of a systolic heart murmur
• D. Apical pulse rate of 50 beats/minute

Correct answer: D

Rationale: An apical pulse rate of 50 beats/minute indicates bradycardia, a heart rate below the normal range, which requires immediate nursing intervention before administering medication to address the potential impact of the bradycardia on the patient's overall condition.

3. A client is taking levodopa-carbidopa for Parkinson's disease. The nurse should include which instruction when educating the client about this medication?

• A. Increase fluid intake to prevent dehydration.
• B. Take medication with food to improve absorption.
• C. Take medication at bedtime to avoid daytime drowsiness.
• D. It can cause nausea and dizziness.

Correct answer: A

Rationale: The correct instruction for a client taking levodopa-carbidopa for Parkinson's disease is to increase fluid intake to prevent dehydration. Levodopa-carbidopa should be taken with food to reduce gastrointestinal upset and improve absorption. Taking medication at bedtime is not necessary to avoid daytime drowsiness. It is crucial to prevent dehydration due to the medication's side effects. Choice B is incorrect because the medication should be taken with food, not at bedtime. Choice C is incorrect as taking the medication with food, rather than on an empty stomach, aids in absorption and reduces gastrointestinal side effects. Choice D is incorrect as it states the side effects of the medication rather than providing specific instructions on its administration.

4. The nurse is caring for a patient with short-term persistent diarrhea. Which class of medication would the nurse anticipate giving?

• A. Lubricants
• B. Probiotics
• C. Adsorbents
• D. Anticholinergics

Correct answer: B

Rationale: Probiotics are the correct choice in this scenario as they help restore normal gut flora, which can be effective in treating diarrhea by promoting a healthy balance of bacteria in the intestines. Lubricants are used to ease bowel movements and are not indicated for treating diarrhea. Adsorbents work by binding to toxins in the gut, which is not the primary mechanism needed for treating diarrhea. Anticholinergics are more commonly used for conditions like overactive bladder and not for short-term persistent diarrhea.

5. When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?

• A. Serum hepatic enzymes
• B. Fingerstick glucose
• C. Stool color and character
• D. Serum electrolytes and ammonia

Correct answer: D

Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition. Options A, B, and C are incorrect because serum hepatic enzymes, fingerstick glucose, and stool color/character are not directly related to monitoring the response to lactulose therapy in hepatic encephalopathy.

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