Nursing Elites

1. A nurse is reviewing the medical record of a client who has a new prescription for spironolactone. Which of the following findings should the nurse report to the provider?

• A. Potassium 4.0 mEq/L
• B. Calcium 9.5 mg/dL
• C. Magnesium 2.0 mEq/L
• D. Serum creatinine 3.0 mg/dL

Correct answer: D

Rationale: A serum creatinine level of 3.0 mg/dL indicates impaired kidney function, which is a concern when prescribing spironolactone as it can further affect renal function. Elevated serum creatinine levels may suggest decreased renal clearance of spironolactone, leading to potential toxicity. Potassium, calcium, and magnesium levels are within normal ranges and not directly related to spironolactone therapy. Therefore, the nurse should report the elevated serum creatinine level to the provider for further evaluation and possible dosage adjustment.

2. A client is receiving warfarin for atrial fibrillation. Which of the following laboratory tests should the nurse expect to be ordered to monitor the effect of warfarin?

• A. Platelet count
• B. International normalized ratio (INR)
• C. Prothrombin time (PT)
• D. Partial thromboplastin time (PTT)

Correct answer: B

Rationale: The correct answer is B: International normalized ratio (INR). When a client is on warfarin therapy, the INR is monitored regularly to assess the anticoagulant effects of the medication. A therapeutic INR range for most indications is between 2.0 to 3.0. Choices A, C, and D are not typically used to monitor the effect of warfarin. Platelet count assesses the number of platelets in the blood, PT measures the clotting time of plasma, and PTT evaluates the intrinsic pathway of coagulation.

3. What should the healthcare provider monitor for a patient receiving furosemide?

• A. Monitor urine output
• B. Monitor blood pressure
• C. Monitor potassium levels
• D. Monitor serum creatinine

Correct answer: C

Rationale: The correct answer is to monitor potassium levels when a patient is receiving furosemide because furosemide can cause potassium depletion. It is essential to monitor potassium levels to prevent complications such as hypokalemia. While monitoring urine output is important in assessing kidney function, and monitoring blood pressure and serum creatinine are relevant in certain situations, the priority when administering furosemide is to monitor potassium levels due to the medication's potential to deplete potassium.

4. A nurse is preparing to administer a dose of vancomycin IV to a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the following actions should the nurse take?

• A. Administer the medication over 15 minutes.
• B. Monitor the client's urine output every 8 hours.
• C. Check the client's creatinine level before administering the medication.
• D. Assess the client for a history of allergies to antibiotics.

Correct answer: C

Rationale: The correct action for the nurse to take is to check the client's creatinine level before administering vancomycin. Vancomycin is known to be nephrotoxic, so assessing the client's renal function before administering the medication is crucial to prevent further kidney damage. Administering the medication over 15 minutes (Choice A) is not the priority in this scenario as renal function assessment takes precedence. Monitoring urine output (Choice B) is important for assessing renal function but checking creatinine level directly provides more accurate information. Assessing for allergies to antibiotics (Choice D) is also important but not as essential as checking the creatinine level due to the nephrotoxic nature of vancomycin.

5. During an emergency response following a disaster, which client should be recommended for early discharge?

• A. A client with COPD and a respiratory rate of 44/min.
• B. A client with cancer and a sealed implant for radiation therapy.
• C. A client receiving heparin for deep-vein thrombosis.
• D. A client who is 1 day postoperative following a vertebroplasty.

Correct answer: D

Rationale: The client who is 1 day postoperative following a vertebroplasty is stable and can be discharged early. In an emergency response situation, it is crucial to prioritize clients who are medically stable and do not require immediate hospital care. The client with COPD and a respiratory rate of 44/min needs close monitoring and intervention. The client with cancer and a sealed implant for radiation therapy requires specialized care and follow-up. The client receiving heparin for deep-vein thrombosis needs ongoing anticoagulant therapy and monitoring, making early discharge not appropriate.

Similar Questions