Nursing Elites

1. A client has a new prescription for Atenolol. Which of the following instructions should the nurse provide?

• A. Take this medication with grapefruit juice.
• B. Monitor your blood pressure and heart rate regularly.
• C. You may experience a rapid heart rate.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Monitor your blood pressure and heart rate regularly.' Atenolol is a beta-blocker used to treat hypertension and other cardiovascular conditions. Patients should monitor their blood pressure and heart rate regularly to assess the medication's effectiveness and check for adverse effects like bradycardia or hypotension. Choice A is incorrect because Atenolol should not be taken with grapefruit juice, which can interfere with its absorption. Choice C is incorrect because Atenolol typically causes a decrease in heart rate, not a rapid heart rate. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Atenolol.

2. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?

• A. Instruct the client to self-ambulate every 2 hours.
• B. Offer oral hygiene every 2 hours.
• C. Anticipate medication administration 2 hours prior to delivery.
• D. Monitor fetal heart rate every 2 hours.

Correct answer: B

Rationale: Offering oral hygiene every 2 hours is essential for a client receiving opioid analgesics to prevent dry mouth, nausea, and vomiting, which are common adverse effects associated with opioid use. This intervention promotes comfort and enhances the client's well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate for a client in labor receiving opioid analgesics, as it may be challenging and unnecessary during this time. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's pain level and the duration of action of the opioid. Monitoring fetal heart rate every 2 hours is important during labor, but the priority in this case is to address the client's comfort and well-being by offering oral hygiene.

3. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.

4. A healthcare provider is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare provider should monitor the client for which of the following as an adverse effect of this medication?

• A. Bradycardia
• B. Hyperkalemia
• C. Hypoglycemia
• D. Hypocalcemia

Correct answer: B

Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, leading to potassium retention. Monitoring potassium levels is essential to prevent complications associated with hyperkalemia. Bradycardia (Choice A) is not a common adverse effect of Enalapril. Enalapril does not typically affect glucose levels, so hypoglycemia (Choice C) is not a common concern with this medication. Enalapril does not directly impact calcium levels, so hypocalcemia (Choice D) is not a typical adverse effect.

5. A client is taking Somatropin to stimulate growth. The healthcare provider should plan to monitor the client's urine for which of the following?

• A. Bilirubin
• B. Protein
• C. Potassium
• D. Calcium

Correct answer: D

Rationale: When a client is taking Somatropin to stimulate growth, monitoring calcium levels in the urine is crucial. Excessive calcium excretion can occur in the urine of clients taking Somatropin, increasing the risk of renal calculi. Therefore, monitoring calcium levels is essential to assess for potential kidney stone formation. Bilirubin, protein, and potassium are not specifically monitored in the urine of clients taking Somatropin for growth stimulation.

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