Nursing Elites

1. A client with a UTI and a history of recurrent infections asks why the provider has not yet prescribed an antibiotic. The nurse should explain that the provider has to wait for the results of which of the following laboratory tests to identify which antibiotic to prescribe?

• A. Gram stain
• B. Culture
• C. Sensitivity
• D. Specific gravity

Correct answer: C

Rationale: In the case of a UTI, a sensitivity test is crucial as it identifies the most effective antibiotic to target the specific microorganism causing the infection. This test helps in prescribing the appropriate antibiotic for successful treatment and preventing antibiotic resistance. While a Gram stain and culture are important in diagnosing a UTI, the sensitivity test specifically determines the most suitable antibiotic. Specific gravity, on the other hand, is not related to identifying the appropriate antibiotic for a UTI.

2. A client has been prescribed a new oral hypoglycemic agent for diabetes. Which of the following statements by the client indicates a need for further teaching?

• A. I will take this medication with my evening snack.
• B. I will monitor my blood sugar levels before each meal.
• C. I will take this medication as soon as I wake up.
• D. I will follow my exercise plan as usual.

Correct answer: A

Rationale: Taking an oral hypoglycemic agent with an evening snack may lead to hypoglycemia during the night. It is important to follow the prescribed timing for medication administration to maintain blood sugar levels within the target range. The medication is usually taken before meals to help control postprandial blood glucose levels effectively. Choice B is correct as monitoring blood sugar levels before each meal is a good practice. Choice C is incorrect as taking the medication upon waking up may align with certain oral hypoglycemic agents' dosing schedules. Choice D is also correct as regular exercise is an important part of managing diabetes.

3. 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.

4. While providing an Angiotensin-converting enzyme (ACE) inhibitor, the patient asks what the action of the drug is. As a healthcare provider, you explain that the action of an ACE inhibitor is:

• A. To lower blood pressure by blocking the conversion of angiotensin I to vasoconstrictor angiotensin II
• B. To inhibit reabsorption of sodium back into the body, ultimately increasing urine output and lowering blood pressure
• C. To decrease heart rate and blood pressure by competing with Beta1 and Beta2 receptors in the heart and lungs
• D. To lower blood glucose by stimulating the release of insulin

Correct answer: A

Rationale: ACE inhibitors lower blood pressure by blocking the conversion of angiotensin I to vasoconstrictor angiotensin II. Angiotensin II is a potent vasoconstrictor, and by inhibiting its formation, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload on the heart. Choice B is incorrect as it describes the mechanism of action of diuretics, not ACE inhibitors. Choice C is incorrect as it refers to the action of beta-blockers, not ACE inhibitors. Choice D is incorrect as it describes the mechanism of action of antidiabetic medications, not ACE inhibitors.

5. What is the therapeutic classification of Furosemide?

• A. Antidiuretics
• B. Diuretics
• C. Anticonvulsants
• D. Antidotes

Correct answer: B

Rationale: Furosemide is classified therapeutically as a diuretic. Diuretics are medications used to promote diuresis, which helps the body get rid of excess salt and water. Furosemide is commonly prescribed to treat conditions such as fluid retention and swelling (edema) associated with congestive heart failure, liver disease, or kidney disorders. Choice A, Antidiuretics, is incorrect as Furosemide acts as a diuretic, promoting the production of urine. Choice C, Anticonvulsants, is also incorrect as Furosemide is not used to treat seizures. Choice D, Antidotes, is incorrect as Furosemide is not an antidote but rather a medication used to treat conditions related to fluid retention.

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