Nursing Elites

1. A client informs a healthcare professional about taking Gingko Biloba. Which of the following medications is contraindicated for a client using Gingko Biloba?

• A. Acetaminophen
• B. Warfarin
• C. Digoxin
• D. Lisinopril

Correct answer: B

Rationale: Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction that can lead to suppressed coagulation and an increased risk of bleeding or hemorrhage. Warfarin is an anticoagulant, and when combined with Gingko Biloba, which also has anticoagulant properties, the risk of bleeding complications is significantly heightened. Acetaminophen (Choice A), Digoxin (Choice C), and Lisinopril (Choice D) do not have significant interactions with Gingko Biloba compared to Warfarin. Acetaminophen is a pain reliever, Digoxin is a medication for heart conditions, and Lisinopril is an ACE inhibitor for hypertension.

2. A healthcare professional is administering a Dopamine infusion at a low dose to a client with severe heart failure. Which of the following findings is an expected effect of this medication?

• A. Lowered heart rate
• B. Increased myocardial contractility
• C. Decreased conduction through the AV node
• D. Vasoconstriction of renal blood vessels

Correct answer: B

Rationale: Dopamine, when administered at a low dose, is expected to increase myocardial contractility by stimulating beta1 receptors. This positive inotropic effect leads to an increase in cardiac output. Therefore, the correct answer is increased myocardial contractility, as it is a desired effect of administering dopamine to a client with severe heart failure.

3. 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.

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

• A. Take the medication with a full glass of water.
• B. Avoid activities that require alertness.
• C. Increase your intake of high-fiber foods.
• D. Expect your stools to be black and tarry.

Correct answer: B

Rationale: The correct answer is B. Loperamide can cause drowsiness and dizziness, so clients should avoid activities that require alertness until they know how the medication affects them. Taking the medication with a full glass of water can help with absorption. Increasing intake of high-fiber foods is not directly related to Loperamide. Black, tarry stools are not expected side effects of this medication, so informing the client to expect this is incorrect.

5. What are the Therapeutic Effects of Lithium?

• A. Prevents or decreases the incidence of acute manic episodes
• B. Maintenance of blood glucose
• C. Control of hyperglycemia in diabetic patients
• D. Diminished seizure activity

Correct answer: A

Rationale: The therapeutic effect of lithium is that it prevents or decreases the incidence of acute manic episodes in patients with bipolar disorder. Lithium is commonly used as a mood stabilizer in the treatment of bipolar disorder due to its ability to reduce the frequency and severity of manic episodes. Choices B, C, and D are incorrect as lithium is not used for the maintenance of blood glucose, control of hyperglycemia in diabetic patients, or to diminish seizure activity. These effects are not associated with the use of lithium as a medication.

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