Nursing Elites

1. When caring for a client prescribed Lithium, which laboratory value should the nurse monitor to assess for potential toxicity?

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

Correct answer: B

Rationale: The nurse should monitor the client's serum lithium levels to ensure they are within the therapeutic range and to assess for potential toxicity. Monitoring serum lithium levels is crucial because lithium has a narrow therapeutic range, and levels outside this range can lead to toxicity, which can be life-threatening. Therefore, regular monitoring is essential to prevent adverse effects and ensure the medication's effectiveness.

2. How can the nurse best explain the difference between angina and a myocardial infarction to a client presenting with severe chest pain?

• A. “Angina usually resolves with rest, and is rarely fatal, while a myocardial infarction necessitates immediate treatment and can be life-threatening.”
• B. “There is a clear distinction between the two. You will receive treatment based on the diagnosis of a myocardial infarction.”
• C. “Both conditions result from a clot obstructing the coronary arteries. Angina occurs with the blockage of a small vessel, whereas a myocardial infarction occurs with a blockage of a large vessel.”
• D. “Angina may not cause as intense chest pain, whereas a myocardial infarction always presents with severe chest pain.”

Correct answer: A

Rationale: When educating a client about the differences between angina and a myocardial infarction, it is crucial to emphasize key distinguishing factors. Angina typically improves with rest and is not usually life-threatening, whereas a myocardial infarction requires urgent intervention as it can be life-threatening. This explanation helps the client understand the urgency and severity associated with a myocardial infarction compared to angina.

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

• A. Take this medication before meals.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication before meals.' Omeprazole is a proton pump inhibitor that should be taken before meals to be most effective in reducing stomach acid production. Taking it before meals allows the medication to inhibit the proton pumps in the stomach when they are most active, leading to better control of acid secretion. Choice B is incorrect because taking Omeprazole with food may reduce its effectiveness as food can interfere with its absorption. Choice C is incorrect as Omeprazole is more effective when taken before meals. Choice D is incorrect as Omeprazole should not be taken with antacids as they can reduce its absorption.

4. When teaching a client with a new prescription for Ipratropium, which of the following instructions should the nurse include?

• A. This medication can be used as a rescue inhaler.
• B. This medication should be taken before albuterol.
• C. Wait 5 minutes between medications if two inhaled medications are prescribed.
• D. Ipratropium can be used before exercise.

Correct answer: C

Rationale: When two inhaled medications are prescribed, waiting 5 minutes between medications allows for optimal absorption and effectiveness of each medication. This ensures that each medication can work properly without interference from the other, improving the client's respiratory condition.

5. A client is being discharged and will start long-term oral prednisone for chronic asthma treatment. The client should monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is an adverse effect of oral prednisone due to sodium and water retention, which leads to fluid retention. This can be monitored by tracking weight changes. Nervousness (Choice B) is not a common adverse effect of prednisone. Bradycardia (Choice C) is not typically associated with prednisone use; in fact, tachycardia can be more common. Constipation (Choice D) is not a prominent adverse effect of prednisone.

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