Nursing Elites

1. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function, potentially due to Furosemide therapy. This finding can suggest inadequate renal perfusion and impaired drug clearance, necessitating immediate reporting to prevent further complications like electrolyte imbalances and worsening heart failure. Choice A: Weight loss may be expected in heart failure patients due to fluid retention, but it is not an immediate concern. Choice B: A blood pressure of 104/60 mm Hg is slightly low but not a priority compared to the indication of kidney dysfunction. Choice C: A potassium level of 3.5 mEq/L is within the normal range, so it does not require immediate reporting.

2. A client is being taught about Terbutaline. Which statement by the client indicates understanding of the teaching?

• A. This medication will stop my contractions.
• B. This medication will prevent vaginal bleeding.
• C. This medication will promote blood flow to my baby.
• D. This medication will increase my prostaglandin production.

Correct answer: A

Rationale: The correct answer is A. Terbutaline works by blocking beta2-adrenergic receptors, leading to uterine smooth muscle relaxation and stopping contractions. Therefore, the client demonstrating understanding by recognizing that the medication will stop contractions is the most accurate response. Choices B, C, and D are incorrect because Terbutaline is primarily used to inhibit contractions in preterm labor, not prevent vaginal bleeding, promote blood flow to the baby, or increase prostaglandin production.

3. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

4. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

5. What is the antidote for Heparin?

• A. Atropine
• B. Protamine sulfate
• C. Calcium carbonate
• D. Ferrous sulfate

Correct answer: B

Rationale: Protamine sulfate is the specific antidote used to reverse the effects of Heparin by binding to heparin and neutralizing its anticoagulant properties. It is crucial to administer Protamine sulfate promptly in cases of Heparin overdose or when immediate reversal of Heparin's effects is required to prevent bleeding complications. Atropine is not the antidote for Heparin; it is commonly used for treating bradycardia. Calcium carbonate is used to treat conditions like acid indigestion, heartburn, or calcium deficiency. Ferrous sulfate is a form of iron supplement used to treat or prevent iron deficiency anemia. None of these alternatives are antidotes for Heparin.

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