Nursing Elites

1. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.

2. A nurse is teaching a client who has a new prescription for Furosemide. Which of the following dietary instructions should the nurse provide?

• A. Increase your intake of potassium-rich foods.
• B. Limit your intake of calcium-rich foods.
• C. Avoid consuming dairy products.
• D. Increase your intake of fiber-rich foods.

Correct answer: A

Rationale: Furosemide, a loop diuretic, can cause potassium loss. Clients should increase their intake of potassium-rich foods to prevent hypokalemia.

3. A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

• A. Document that the client experienced an anaphylactic reaction to the medication.
• B. Change the IV infusion site.
• C. Decrease the infusion rate on the IV.
• D. Apply cold compresses to the neck area.

Correct answer: C

Rationale: Flushing and tachycardia are signs of Red Man Syndrome, which can be mitigated by decreasing the infusion rate.

4. A client has a new prescription for Spironolactone. Which of the following instructions should be provided?

• A. Take the medication with food.
• B. Avoid potassium-rich foods.
• C. Increase your intake of sodium.
• D. Monitor your blood pressure daily.

Correct answer: B

Rationale: The correct answer is to 'Avoid potassium-rich foods.' Spironolactone is a potassium-sparing diuretic, and consuming foods high in potassium can lead to hyperkalemia, a potential side effect of the medication. Therefore, the client should be advised to avoid potassium-rich foods to prevent complications. Choices A, C, and D are incorrect. Taking Spironolactone with food is not necessary for its effectiveness. Increasing sodium intake is not typically recommended with Spironolactone therapy. While monitoring blood pressure is important, it is not specifically related to the use of Spironolactone.

5. A client with Peptic Ulcer Disease who is taking Sucralfate PO has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

• A. Take an antacid with the sucralfate.
• B. Take sucralfate with a glass of milk.
• C. Allow a 2-hour interval between these medications.
• D. Chew the sucralfate thoroughly before swallowing.

Correct answer: C

Rationale: Sucralfate can interfere with the absorption of phenytoin. To prevent this interaction, the client should allow a 2-hour interval between taking sucralfate and phenytoin. This interval helps ensure that each medication is absorbed effectively without affecting the other's absorption. Choices A, B, and D are incorrect because taking an antacid with sucralfate, taking sucralfate with a glass of milk, or chewing sucralfate thoroughly before swallowing are not necessary or recommended instructions to prevent the interaction between sucralfate and phenytoin.

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