Nursing Elites

1. A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the client should be advised to do which of the following?

• A. Avoid using acetaminophen for headaches.
• B. Restrict intake of foods rich in sodium.
• C. Decrease fluid intake to less than 1,500 mL daily.
• D. Limit aerobic activity in hot weather.

Correct answer: D

Rationale: The correct answer is to advise the client to limit aerobic activity in hot weather. Aerobic activity in hot weather can lead to excessive sweating, potentially causing sodium and water depletion, which can increase the risk of Lithium toxicity. It is important for clients taking Lithium to maintain adequate hydration and sodium levels to prevent toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting intake of foods rich in sodium is not recommended because adequate sodium levels are necessary to prevent Lithium toxicity. Decreasing fluid intake to less than 1,500 mL daily is also not advisable as adequate hydration is important to prevent Lithium toxicity.

2. A client is being taught about a new prescription for Escitalopram to treat generalized anxiety disorder. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication with food.
• B. I will monitor my blood sugar levels while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I can crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing Escitalopram, the client should taper the medication slowly according to a prescribed dosing schedule to reduce the risk of withdrawal syndrome. Abruptly stopping the medication can lead to withdrawal symptoms, so it is important to follow the healthcare provider's instructions for gradual discontinuation. Choices A, B, and D are incorrect because Escitalopram should not necessarily be taken with food, there is no direct correlation with blood sugar levels, and the medication should not be crushed before swallowing.

3. A client has a new prescription for Furosemide. Which of the following instructions should be included by the nurse?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction to include when a client is prescribed Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these potential adverse effects.

4. Which of the following is a potassium-sparing diuretic?

• A. Furosemide
• B. Spironolactone
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: B

Rationale: Spironolactone is classified as a potassium-sparing diuretic. It works by antagonizing the aldosterone receptor, leading to potassium retention and sodium excretion. This mechanism makes it a suitable choice for conditions where potassium retention is desired, such as in patients with heart failure or liver cirrhosis. Choices A, C, and D are not potassium-sparing diuretics. Furosemide, hydrochlorothiazide, and bumetanide are loop diuretics and thiazide diuretics, respectively, which promote the excretion of potassium.

5. A client is prescribed Propranolol for dysrhythmia. Which action should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Monitor the client's blood pressure after administering Propranolol.
• C. Assist the client when transitioning to a sitting or standing position after taking Propranolol.
• D. Monitor the client's potassium levels for signs of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol to a client with dysrhythmia is to assist the client when transitioning to a sitting or standing position. Propranolol can cause orthostatic hypotension, leading to dizziness during position changes, so it is essential to help the client move slowly to prevent falls or injuries. Choices A, B, and D are incorrect because holding Propranolol based on pulse rate, monitoring blood pressure after administration, and monitoring potassium levels are not directly related to the common side effect of orthostatic hypotension associated with Propranolol.

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