Nursing Elites

1. A healthcare professional is reviewing laboratory results for a client who has been taking carbamazepine. Which of the following findings should the healthcare professional report to the provider?

• A. WBC count 3,000/mm3
• B. Platelet count 150,000/mm3
• C. Hemoglobin 14 g/dL
• D. Serum potassium 4.5 mEq/L

Correct answer: A

Rationale: A WBC count of 3,000/mm3 indicates leukopenia, a serious side effect of carbamazepine. Leukopenia can increase the risk of infections due to decreased white blood cell count, which is important to report to the provider for further evaluation and management. Platelet count within normal range (choice B), hemoglobin level within normal range (choice C), and serum potassium level within normal range (choice D) are not directly associated with carbamazepine use and do not require immediate reporting as they do not indicate a serious adverse effect.

2. A client diagnosed with hypertension is prescribed atenolol (Tenormin). The nurse should monitor the client for which common side effect of this medication?

• A. Tachycardia
• B. Dry mouth
• C. Hypotension
• D. Increased appetite

Correct answer: C

Rationale: Atenolol is a beta-blocker that works by lowering blood pressure. A common side effect of atenolol is hypotension, where blood pressure drops too low. Therefore, the nurse should monitor the client for signs and symptoms of hypotension to prevent any complications. Choices A, B, and D are incorrect because tachycardia (fast heart rate), dry mouth, and increased appetite are not common side effects of atenolol. Hypotension is the expected side effect due to the medication's mechanism of action.

3. While preparing a client for a cardiac catheterization, the client expresses a preference to speak with their doctor rather than the nurse. Which response by the nurse should be therapeutic?

• A. Your doctor expects me to prepare you for this procedure.
• B. That's fine, if that's what you want. I'll call your health care provider.
• C. So you're saying that you want to talk to your health care provider?
• D. I'm concerned with the way you've dismissed me. I know what I am doing.

Correct answer: C

Rationale: The therapeutic response by the nurse in this situation involves reflecting the client's feelings back to them, which demonstrates active listening and empathy. By restating the client's preference to talk to their doctor, the nurse acknowledges and validates the client's feelings, thereby fostering a positive therapeutic relationship and promoting open communication. Choices A and B do not acknowledge the client's preference and may come off as dismissive. Choice D is confrontational and defensive, which can lead to a breakdown in communication and trust between the nurse and the client.

4. The healthcare professional is assisting in the care of a client diagnosed with heart failure. The client is receiving furosemide (Lasix). Which laboratory value should the healthcare professional monitor most closely?

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

Correct answer: B

Rationale: Furosemide is a loop diuretic that can lead to significant potassium loss, making it crucial to monitor the client's serum potassium levels. Hypokalemia (low potassium levels) can result from furosemide use, potentially leading to adverse effects such as cardiac dysrhythmias. Therefore, close monitoring of serum potassium levels is essential to prevent complications in clients receiving furosemide. Monitoring serum calcium, sodium, or glucose levels is not the priority when administering furosemide.

5. The healthcare provider is caring for a client with hypertension who is receiving a beta blocker. The provider should monitor for which potential side effect?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: Corrected Rationale: Beta blockers are medications that can cause bradycardia by slowing down the heart rate. It is essential to monitor for this side effect in clients receiving beta blockers, as it can lead to serious complications such as decreased cardiac output and hypotension. Choices A, C, and D are incorrect because beta blockers are not expected to cause tachycardia (fast heart rate), hypertension (high blood pressure), or hyperglycemia (high blood sugar levels).

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