Nursing Elites

1. A client in an acute mental health facility is experiencing withdrawal from Opioid use and has a new prescription for Clonidine. Which of the following actions should the nurse identify as the priority?

• A. Administer the clonidine on the prescribed schedule.
• B. Provide ice chips at the client's bedside.
• C. Educate the client on the effects of clonidine.
• D. Obtain baseline vital signs.

Correct answer: D

Rationale: In this scenario, the priority action for the nurse is to obtain baseline vital signs. This step is crucial in assessing the client's current physiological status and establishing a reference point for monitoring the effects of Clonidine. Administering the medication, providing ice chips, and educating the client are important tasks but assessing the client's vital signs takes precedence to ensure the client's safety and well-being during withdrawal management.

2. A healthcare professional is preparing to administer furosemide 80 mg PO daily. The available furosemide oral solution is 10 mg/1 mL. How many mL should the healthcare professional administer?

• A. 8 mL
• B. 10 mL
• C. 6 mL
• D. 12 mL

Correct answer: A

Rationale: To determine the volume to administer, divide the desired dose by the available concentration. In this case, (80 mg / 10 mg/mL) = 8 mL. Therefore, the healthcare professional should administer 8 mL of furosemide oral solution. Choice B (10 mL), C (6 mL), and D (12 mL) are incorrect as they do not accurately calculate the volume needed based on the provided concentration of the solution.

3. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: Corrected Question: When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor? Amitriptyline is known to cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down or sitting to a standing position. Monitoring for orthostatic hypotension is crucial to prevent falls and related injuries. Educating the client about moving slowly and changing positions gradually can help mitigate this adverse effect. Choices A, B, and C are incorrect because decreased appetite, explosive diarrhea, and decreased pulse rate are not commonly associated with Amitriptyline use. Therefore, the correct answer is D.

4. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.

5. A healthcare professional is preparing to administer morphine 4 mg IV to a client. Available is morphine 10 mg/mL. How many mL should the healthcare professional administer?

• A. 0.2 mL
• B. 0.4 mL
• C. 0.6 mL
• D. 0.8 mL

Correct answer: B

Rationale: To administer 4 mg from a solution of 10 mg/mL, the healthcare professional should administer 0.4 mL. The calculation is done by dividing the desired dose (4 mg) by the concentration of the solution (10 mg/mL), which equals 0.4 mL. Choice A (0.2 mL) is incorrect because it is half of the correct calculation. Choice C (0.6 mL) is incorrect because it is 50% more than the correct calculation. Choice D (0.8 mL) is incorrect because it exceeds the correct calculation.

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