Nursing Elites

1. A client with a new prescription for Verapamil to control hypertension is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?

• A. I should avoid drinking grapefruit juice.
• B. I can expect my heart rate to increase while taking this medication.
• C. This medication will cause my urine to turn orange.
• D. I will stop taking this medication if I experience headaches.

Correct answer: A

Rationale: The correct answer is A. Grapefruit juice can increase blood levels of verapamil, leading to increased effects and potentially serious side effects such as hypotension or bradycardia. It is crucial for the client to avoid grapefruit juice while taking Verapamil to prevent these adverse reactions. Choice B is incorrect because verapamil is a calcium channel blocker that typically lowers heart rate. Choice C is incorrect as verapamil does not cause urine discoloration. Choice D is incorrect because stopping medication abruptly without consulting a healthcare provider can be dangerous.

2. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.

3. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. It is characterized by a decreased level of neutrophils, which are important in fighting infections. Monitoring the client's complete blood count (CBC) is crucial to detect neutropenia early. The nurse should also educate the client on recognizing signs of infection and promptly reporting them to the healthcare provider for timely intervention. Hypokalemia is a potential adverse effect of diuretics, not ACE inhibitors. Hypernatremia is an electrolyte imbalance more commonly associated with conditions like dehydration. Bradycardia is not a typical adverse effect of Captopril.

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

• A. Avoid drinking grapefruit juice.
• B. Take this medication with a full glass of water.
• C. Take this medication on an empty stomach.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct instruction for a client prescribed Losartan is to monitor for signs of dehydration. Losartan can lead to dehydration, so it is essential for the client to be vigilant for symptoms such as dry mouth, increased thirst, and decreased urine output. Providing the instruction to monitor for signs of dehydration ensures the client's safety and helps in early identification of any potential issues related to dehydration. Choices A, B, and C are incorrect as Losartan does not interact with grapefruit juice, does not require specific instructions regarding water intake, and does not need to be taken on an empty stomach.

5. A client is receiving daily doses of Oprelvekin. Which of the following laboratory values should the nurse monitor to determine the effectiveness of this medication?

• A. Hemoglobin
• B. Absolute neutrophil count
• C. Platelet count
• D. Total white blood cell count

Correct answer: C

Rationale: The nurse should monitor the platelet count to determine the effectiveness of Oprelvekin. The expected outcome for this medication is a platelet count greater than 50,000/mm^3. Oprelvekin is a medication used to stimulate platelet production, making platelet count a crucial parameter to assess its effectiveness. Monitoring hemoglobin, absolute neutrophil count, or total white blood cell count is not specifically related to the action or effectiveness of Oprelvekin.

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