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 is taking Desmopressin for Diabetes Insipidus. For which of the following adverse effects should the nurse monitor?

• A. Hypovolemia
• B. Hypercalcemia
• C. Agitation
• D. Headache

Correct answer: D

Rationale: Headache is an adverse effect that the nurse should monitor for in a client taking Desmopressin for Diabetes Insipidus. It can be an early sign of water intoxication, which is a potential complication of desmopressin therapy due to excessive water retention in the body.

3. A client has a new prescription for nitroglycerin. Which of the following adverse effects should the nurse instruct the client to report that can indicate the medication is effective?

• A. Headache
• B. Nausea
• C. Dizziness
• D. Dry mouth

Correct answer: A

Rationale: Headache is a common side effect of nitroglycerin due to its vasodilatory effects. It can indicate that the medication is working effectively by dilating blood vessels, improving blood flow, and reducing cardiac workload. Therefore, the client should report experiencing headaches as it may suggest the therapeutic action of nitroglycerin. Nausea, dizziness, and dry mouth are not typically associated with the therapeutic effects of nitroglycerin and should be reported as adverse effects that may necessitate medical attention.

4. A client is starting therapy with doxorubicin. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The correct answer is 'C: Sore throat.' Doxorubicin is known to have immunosuppressive effects, which can predispose the client to infections. A sore throat can be an early sign of infection, and prompt reporting to the healthcare provider is crucial to initiate appropriate interventions and prevent complications. Choices A, B, and D are incorrect because hair loss, fatigue, and red urine are common side effects of doxorubicin and are typically expected during therapy. While these side effects should be monitored, they do not require immediate reporting unless they become severe or concerning.

5. A client has a new prescription for Losartan. Which of the following laboratory values should the nurse monitor?

• A. Serum potassium
• B. Serum sodium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: Corrected Rationale: Losartan, an angiotensin II receptor blocker (ARB), can cause hyperkalemia. The nurse should monitor the client's serum potassium levels closely because Losartan can increase potassium levels, potentially leading to serious complications such as arrhythmias. Monitoring serum sodium, calcium, or magnesium levels is not typically necessary when a patient is prescribed Losartan, as these values are not directly affected by this medication.

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