Nursing Elites

1. A client has a prescription for Amphotericin B. Which of the following laboratory values should be monitored by the nurse to assess for an adverse effect of this medication?

• A. Serum creatinine.
• B. Serum potassium.
• C. Serum sodium.
• D. Serum calcium.

Correct answer: A

Rationale: Corrected Rationale: Amphotericin B is known to cause nephrotoxicity, a potential adverse effect that can be monitored by checking the client's serum creatinine levels. Regular monitoring of serum creatinine helps in early identification of kidney damage and allows for timely intervention to prevent further complications. Choice B, serum potassium, is not typically associated with adverse effects of Amphotericin B. Choice C, serum sodium, and choice D, serum calcium, are not directly affected by Amphotericin B and are not primary indicators of its adverse effects.

2. 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.

3. When educating a client with a new prescription for Amlodipine, which instruction should the nurse provide?

• A. Increase your intake of dairy products.
• B. Avoid driving until you see how the medication affects you.
• C. Stop taking the medication if you develop a dry cough.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid driving until they understand the medication's effects. Amlodipine can cause dizziness, making it unsafe to drive until the client knows how the medication affects them. This instruction promotes client safety and prevents potential accidents due to medication side effects.

4. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.

5. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

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