Nursing Elites

1. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

• A. Increased renal secretion
• B. Increased medication-metabolizing enzymes
• C. Liver failure
• D. Peripheral vascular disease

Correct answer: C

Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.

2. A client has a new prescription for Lovastatin. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Take this medication in the morning.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct instruction for taking Lovastatin is to take it at bedtime. Cholesterol production in the liver is highest at night, so taking Lovastatin at bedtime aligns with the body's natural rhythm and maximizes its effectiveness.

3. A client with increased liver enzymes is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

• A. Glucosamine
• B. Saw palmetto
• C. Kava
• D. St. John's wort

Correct answer: C

Rationale: The nurse should report kava to the provider because chronic use or high doses of kava can lead to liver damage, including severe liver failure. It is crucial for the nurse to be vigilant about any herbal supplement that could potentially worsen the client's liver condition.

4. A client has a new prescription for Atenolol. Which of the following client statements indicates an understanding of the teaching?

• A. I should monitor my blood pressure regularly.
• B. I will take this medication at bedtime.
• C. I will take this medication with a high-fat meal.
• D. I should increase my intake of potassium-rich foods.

Correct answer: A

Rationale: The correct answer is A. Clients taking Atenolol, a beta-blocker, should monitor their blood pressure regularly to ensure the medication is effectively managing their condition. Monitoring blood pressure helps in assessing the drug's effectiveness and identifying any potential side effects that may influence blood pressure levels. Choices B, C, and D are incorrect because taking Atenolol at bedtime, with a high-fat meal, or increasing potassium-rich foods intake are not recommended actions associated with this medication and do not demonstrate an understanding of the teaching.

5. When starting therapy with trastuzumab, which finding should the nurse instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Dyspnea. Dyspnea can indicate pulmonary toxicity, a severe adverse effect of trastuzumab. It is crucial for the client to report any breathing difficulties promptly to ensure timely intervention and prevent further complications. Choices B, C, and D are incorrect because constipation, tinnitus, and dry mouth are not commonly associated with trastuzumab therapy and are not indicative of serious adverse effects that require immediate attention.

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