Nursing Elites

1. A healthcare provider is assessing a client who takes Lithium Carbonate for the treatment of Bipolar disorder. The provider should recognize which of the following findings as a possible indication of toxicity to this medication?

• A. Severe hypertension
• B. Coarse tremors
• C. Constipation
• D. Muscle spasm

Correct answer: B

Rationale: Coarse tremors are a common sign of Lithium toxicity. It is important for healthcare providers to monitor for this symptom as it indicates a potential overdose of the medication. Severe hypertension, constipation, and muscle spasms are not typically associated with Lithium toxicity. Severe hypertension is not a common sign of Lithium toxicity but rather a symptom of hypertensive crisis. Constipation is not a typical sign of Lithium toxicity but could be seen in other conditions. Muscle spasms are not specific to Lithium toxicity but can occur due to various reasons.

2. 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.

3. When administering a Serotonin Antagonist, what is important to monitor for?

• A. Intake and output
• B. Mental status changes
• C. Respiratory rate
• D. Anorexia

Correct answer: B

Rationale: When administering a Serotonin Antagonist, monitoring mental status changes is crucial. Serotonin Antagonists can affect neurological function, potentially leading to alterations in mental status. It is essential to assess for any changes in behavior, mood, or cognition to ensure patient safety and prompt intervention if needed.

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

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain is not relieved after 5 minutes, the client should call 911 and take a second tablet. Taking more than the recommended dose can lead to serious side effects, and swallowing the tablet would not provide the rapid effect needed in cases of chest pain. Choice A is correct because it aligns with the standard protocol for nitroglycerin use in treating angina. Choice B is incorrect as the second tablet should be taken after 5 minutes, not 10 minutes. Choice C is incorrect as taking up to five tablets in 15 minutes is excessive and can result in serious complications. Choice D is incorrect as nitroglycerin sublingual tablets should be placed under the tongue for rapid absorption, not swallowed.

5. A client is prescribed Bethanechol to treat urinary retention. Which of the following findings is a manifestation of muscarinic stimulation?

• A. Dry mouth
• B. Hypertension
• C. Excessive perspiration
• D. Fecal impaction

Correct answer: C

Rationale: Bethanechol is a muscarinic agonist, which stimulates muscarinic receptors. Activation of these receptors can lead to increased sweating (excessive perspiration) as a manifestation of muscarinic stimulation. Options A, B, and D are not typically associated with muscarinic stimulation. Dry mouth is a common side effect of anticholinergic medications, hypertension is not a common manifestation of muscarinic stimulation, and fecal impaction is not directly related to muscarinic receptor activation.

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