Nursing Elites

1. When teaching a client about preventing Otitis Externa, which of the following instructions should the nurse include?

• A. Clean the ear with a cotton-tipped swab daily.
• B. Place earplugs in the ears when sleeping at night.
• C. Use a cool water irrigation solution to remove earwax.
• D. Tip the head to the side to remove water from the ears after showering.

Correct answer: D

Rationale: To prevent Otitis Externa, the nurse should instruct the client to tip the head to the side to allow water to drain out after showering or swimming. This helps to prevent moisture buildup in the ear canal, reducing the risk of developing Otitis Externa, commonly known as swimmer's ear.

2. A client is receiving Gentamicin. Which of the following laboratory values should the nurse monitor to assess for nephrotoxicity?

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

Correct answer: B

Rationale: When a client is receiving Gentamicin, the nurse should monitor serum creatinine levels to assess for nephrotoxicity. Gentamicin is known to potentially cause nephrotoxicity, leading to impaired kidney function. Monitoring serum creatinine levels helps in early detection of any kidney damage or dysfunction. Serum sodium, serum potassium, and serum glucose levels are not directly related to nephrotoxicity caused by Gentamicin, so they are not the appropriate values to monitor in this case.

3. A healthcare provider is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare provider should monitor the client for which of the following as an adverse effect of this medication?

• A. Bradycardia
• B. Hyperkalemia
• C. Hypoglycemia
• D. Hypocalcemia

Correct answer: B

Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, leading to potassium retention. Monitoring potassium levels is essential to prevent complications associated with hyperkalemia. Bradycardia (Choice A) is not a common adverse effect of Enalapril. Enalapril does not typically affect glucose levels, so hypoglycemia (Choice C) is not a common concern with this medication. Enalapril does not directly impact calcium levels, so hypocalcemia (Choice D) is not a typical adverse effect.

4. A client is receiving moderate sedation with Diazepam IV and is oversedated. Which of the following medications should the nurse anticipate administering to this client?

• A. Ketamine
• B. Naltrexone
• C. Flumazenil
• D. Fluvoxamine

Correct answer: C

Rationale: Flumazenil is a specific benzodiazepine antagonist that competitively reverses the sedative effects of benzodiazepines like Diazepam. In cases of oversedation or respiratory depression caused by benzodiazepines, administering Flumazenil can help reverse the effects and restore the client's consciousness and respiratory drive. Ketamine (Choice A) is a dissociative anesthetic and not used to reverse benzodiazepine sedation. Naltrexone (Choice B) is an opioid receptor antagonist and not indicated for benzodiazepine oversedation. Fluvoxamine (Choice D) is an antidepressant and not used to counteract benzodiazepine sedation.

5. A client is starting therapy with raloxifene. Which adverse effect should the client monitor for as instructed by the nurse?

• A. Leg cramps
• B. Hot flashes
• C. Urinary frequency
• D. Hair loss

Correct answer: B

Rationale: Hot flashes are a common adverse effect associated with raloxifene therapy. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent and treat osteoporosis in postmenopausal women. Hot flashes are a well-known side effect of SERMs due to their estrogen-like effects on the body. Leg cramps, urinary frequency, and hair loss are not typically associated with raloxifene therapy. Therefore, the nurse should instruct the client to monitor for hot flashes as part of the medication education.

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