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 client in a substance abuse clinic is being assessed by a nurse after discontinuing disulfiram due to severe nausea and vomiting. What is the likely cause of the client's distress?

• A. The client demonstrated an allergic response to the medication.
• B. The client experienced a common side effect of the medication.
• C. The client consumed alcohol while taking the medication.
• D. The client took an overdose of the medication.

Correct answer: C

Rationale: Disulfiram, when combined with alcohol, leads to a severe reaction causing nausea and vomiting. Since the client experienced these symptoms after starting disulfiram, it is likely that they consumed alcohol while taking the medication. Choice A is incorrect because the symptoms are more indicative of the interaction with alcohol rather than an allergic response. Choice B is incorrect as severe nausea and vomiting are not common side effects of disulfiram alone. Choice D is incorrect as there is no indication of an overdose based on the symptoms described.

3. Which of the following types of insulin is classified as 'long-acting'?

• A. Lispro (Humalog)
• B. NPH (Humulin N)
• C. Regular insulin (Humulin R)
• D. Glargine (Lantus)

Correct answer: D

Rationale: The correct answer is Glargine (Lantus). Glargine is classified as a long-acting insulin due to its slow, steady release over an extended period, making it suitable for basal insulin requirements. It has a duration of action that can last up to 24 hours, helping to maintain stable blood sugar levels throughout the day. Lispro (Humalog) is a rapid-acting insulin, NPH (Humulin N) is an intermediate-acting insulin, and Regular insulin (Humulin R) is a short-acting insulin, so they are not classified as long-acting insulins.

4. A client with Atrial Fibrillation is prescribed Dabigatran to prevent Thrombosis. Which medication is prescribed concurrently to treat an adverse effect of Dabigatran?

• A. Vitamin K1
• B. Protamine
• C. Omeprazole
• D. Probenecid

Correct answer: C

Rationale: Omeprazole or another proton pump inhibitor is commonly prescribed for clients taking dabigatran who experience abdominal pain and other gastrointestinal adverse effects associated with dabigatran use. Proton pump inhibitors help alleviate these symptoms by reducing gastric acid secretion, which can contribute to gastrointestinal discomfort. Vitamin K1 is not indicated for adverse effects of dabigatran. Protamine is used to reverse the anticoagulant effects of heparin, not dabigatran. Probenecid is not typically used to treat adverse effects of dabigatran.

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

• A. Take this medication in the morning.
• B. Consume foods rich in potassium.
• C. Take this medication with a meal.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: Hydrochlorothiazide is a diuretic that can lead to dehydration due to increased urination. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. It is essential to educate the client to monitor these signs and seek medical attention if they occur. Choice A is incorrect because Hydrochlorothiazide is usually taken in the morning to prevent disruption of sleep due to increased urination during the night. Choice B is incorrect because while Hydrochlorothiazide can lead to potassium loss, consuming foods rich in potassium is not a specific instruction related to this medication. Choice C is incorrect because taking Hydrochlorothiazide with a meal is not a specific requirement for its administration.

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