Nursing Elites

1. A client has a new prescription for Metronidazole. Which of the following instructions should be included?

• A. Avoid drinking alcohol while taking this medication.
• B. Take the medication on an empty stomach.
• C. Increase your intake of green, leafy vegetables.
• D. Discontinue the medication if you experience a metallic taste.

Correct answer: A

Rationale: The correct instruction for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Metronidazole can cause a disulfiram-like reaction when combined with alcohol, resulting in severe nausea, vomiting, and other adverse effects. Therefore, it is crucial for clients to refrain from consuming alcohol during treatment to prevent these potential complications. Choice B is incorrect because Metronidazole can be taken with or without food. Choice C is irrelevant as there is no specific requirement to increase green, leafy vegetable intake with Metronidazole. Choice D is incorrect as a metallic taste is a known side effect of Metronidazole but does not necessarily indicate the need to discontinue the medication.

2. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in clients with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is characterized by inflammation of a vein with the formation of a clot, and estrogen can further exacerbate this condition, leading to serious complications. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and osteoporosis are conditions where estrogen therapy may actually be indicated. Dysfunctional uterine bleeding is another condition where estrogen therapy can be used to help regulate menstrual bleeding.

3. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.

4. A healthcare provider is assessing a client who is taking levothyroxine. The healthcare provider should recognize that which of the following findings is a manifestation of levothyroxine overdose?

• A. Insomnia
• B. Constipation
• C. Drowsiness
• D. Hypoactive deep-tendon reflexes

Correct answer: A

Rationale: Insomnia is a common symptom of levothyroxine overdose due to excessive stimulation of the central nervous system. Levothyroxine is a thyroid hormone replacement medication, and an overdose can lead to hyperthyroidism symptoms, including insomnia. Constipation and drowsiness are not typically associated with levothyroxine overdose. Hypoactive deep-tendon reflexes are more indicative of hypothyroidism rather than an overdose of levothyroxine.

5. A healthcare professional is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the healthcare professional?

• 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: Performing immediate gastric lavage is the appropriate action for a client with severe lithium toxicity, indicated by a plasma lithium level of 2.1 mEq/L. Gastric lavage can help reduce the client's lithium level by removing the unabsorbed drug from the stomach.

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