Nursing Elites

1. A healthcare provider is caring for a client who is prescribed Furosemide. Which of the following laboratory values should the healthcare provider monitor?

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

Correct answer: A

Rationale: Furosemide is a loop diuretic that can cause hypokalemia (low potassium levels) due to increased potassium excretion in the urine. Monitoring serum potassium levels is crucial to prevent complications such as cardiac arrhythmias. Therefore, the healthcare provider should closely monitor the client's serum potassium levels when they are prescribed Furosemide. While monitoring other electrolytes like sodium and magnesium may also be important in certain situations, the priority for a client prescribed Furosemide is to monitor serum potassium levels due to the risk of hypokalemia.

2. When teaching a client with a new prescription for Timolol how to insert eye drops, which instruction should the nurse include?

• A. Press your finger on the inside corner of your eye for 1 minute after application.
• B. Apply the eye drops directly on the cornea.
• C. Drop the prescribed amount of medication into the center of the conjunctival sac.
• D. Wipe your eyes gently with a tissue immediately after application.

Correct answer: C

Rationale: The correct way to administer eye drops is by instructing the client to drop the prescribed amount of medication into the center of the conjunctival sac. This technique helps in proper distribution and absorption of the medication. Choice A is incorrect as pressing the inside corner of the eye is not necessary. Choice B is incorrect because applying eye drops directly on the cornea can cause irritation and discomfort. Choice D is incorrect as wiping the eyes immediately after application can remove the medication and reduce its effectiveness.

3. A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?

• A. Metformin
• B. Metoprolol
• C. Lisinopril
• D. Insulin

Correct answer: A

Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.

4. Which drug undergoes extensive first-pass hepatic metabolism?

• A. Heparin
• B. Insulin
• C. Propranolol
• D. Nitroglycerin

Correct answer: C

Rationale: Propranolol undergoes extensive first-pass hepatic metabolism in the liver. When administered orally, propranolol is extensively metabolized by the liver before reaching systemic circulation, leading to reduced bioavailability. This process is known as first-pass hepatic metabolism, which significantly affects the drug's effectiveness and necessitates higher oral doses compared to other routes of administration. Heparin (Choice A) is not metabolized by the liver but excreted unchanged by the kidneys. Insulin (Choice B) is a peptide hormone that is not subject to significant first-pass metabolism. Nitroglycerin (Choice D) is primarily metabolized in the blood and tissues, bypassing significant first-pass metabolism in the liver.

5. A client with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.

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