Nursing Elites

1. A client has a new prescription for spironolactone. The client should be monitored for which of the following adverse effects?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypokalemia
• D. Hypercalcemia

Correct answer: A

Rationale: Corrected Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia as an adverse effect. Hyperkalemia is characterized by elevated levels of potassium in the blood, which can be dangerous and lead to cardiac arrhythmias. Therefore, monitoring for signs and symptoms of hyperkalemia is crucial when a client is taking spironolactone. Choices B, C, and D are incorrect because spironolactone is not known to cause hyponatremia, hypokalemia, or hypercalcemia as adverse effects.

2. A client who takes Chlorpromazine for the treatment of Schizophrenia is due for a follow-up assessment. The nurse should expect the greatest improvement in which of the following manifestations? (Select all that apply.)

• A. Disorganized speech.
• B. Bizarre behavior.
• C. Impaired social interactions.
• D. Hallucinations.

Correct answer: A

Rationale: When a client takes a conventional antipsychotic medication like chlorpromazine, the greatest improvement is typically seen in positive symptoms such as disorganized speech. These medications are more effective in managing positive symptoms like disorganized speech rather than negative symptoms like impaired social interactions or hallucinations. Therefore, the nurse should anticipate improvement in disorganized speech as a positive response to chlorpromazine treatment.

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

• A. Avoid drinking grapefruit juice.
• B. Take the medication with your evening meal.
• C. Increase your intake of leafy green vegetables.
• D. Stop taking the medication if you experience muscle pain.

Correct answer: A

Rationale: The correct answer is A: 'Avoid drinking grapefruit juice.' Grapefruit juice should be avoided when taking Atorvastatin because it can increase the blood levels of the medication, potentially leading to a higher risk of adverse effects like muscle pain and liver damage. It is important to follow this instruction to ensure the safe and effective use of Atorvastatin. Choices B, C, and D are incorrect. Taking Atorvastatin with food, specifically a low-fat meal, is recommended, but it is not necessary to specify the evening meal. While increasing intake of leafy green vegetables is generally beneficial for health, it is not a specific instruction for Atorvastatin. Lastly, stopping the medication if one experiences muscle pain is not advisable without consulting a healthcare provider, as muscle pain can be a symptom of a serious side effect of Atorvastatin that requires medical attention.

4. A healthcare professional in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?

• A. Calcium 9.2 mg/dL
• B. Calcium 10.3 mg/dL
• C. Potassium 3.4 mEq/L
• D. Potassium 4.8 mEq/L

Correct answer: C

Rationale: The correct answer is C: Potassium 3.4 mEq/L. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, especially in older clients taking Digoxin, as potassium plays a crucial role in the heart's electrical activity. Choices A and B are related to calcium levels, which do not directly increase the risk of Digoxin toxicity. Choice D, Potassium 4.8 mEq/L, is within the expected reference range and would not increase the risk of Digoxin toxicity.

5. A client is admitted for a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine is known to produce psychological effects, such as hallucinations. Therefore, individuals with schizophrenia are at increased risk of experiencing exacerbation of their symptoms if given Ketamine, making it a contraindication for its use as an intravenous anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for Ketamine use as an intravenous anesthetic.

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