Nursing Elites

1. A client in the operating room received a dose of Succinylcholine, leading to muscle rigidity and a sudden rise in body temperature. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: C

Rationale: Muscle rigidity and a sudden rise in temperature are indicative of malignant hyperthermia, a potential complication of succinylcholine. Dantrolene is the drug of choice to treat malignant hyperthermia as it acts on skeletal muscles to reduce metabolic activity and counteract the symptoms. Neostigmine (Choice A) is used to reverse the effects of non-depolarizing neuromuscular blocking agents, not for malignant hyperthermia. Naloxone (Choice B) is an opioid antagonist used for opioid overdose. Vecuronium (Choice D) is a non-depolarizing neuromuscular blocking agent and is not the appropriate medication for malignant hyperthermia.

2. While caring for a client receiving IV heparin, which of the following findings should the nurse identify as an adverse effect of this medication?

• A. Hypertension
• B. Hyperglycemia
• C. Thrombocytopenia
• D. Leukopenia

Correct answer: C

Rationale: Thrombocytopenia, a decrease in platelet count, is a known adverse effect associated with heparin therapy. It can lead to an increased risk of bleeding and should be closely monitored during treatment. Choices A, B, and D are incorrect. Hypertension is not typically associated with heparin use; hyperglycemia is not a common adverse effect of heparin; leukopenia is not a primary side effect of heparin therapy.

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

• A. Take this medication with food.
• B. Avoid taking aspirin while on this medication.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking aspirin while on this medication.' Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs also affect platelet function and can further increase the risk of bleeding when combined with Clopidogrel. Therefore, it is important for the client to avoid taking aspirin while on this medication to reduce the risk of excessive bleeding. Choices A, C, and D are incorrect because there is no specific requirement to take Clopidogrel with food, avoid foods high in potassium, or take it at bedtime. The key instruction here is to avoid aspirin to prevent potential bleeding complications.

4. A healthcare provider is providing instructions to the parent of an adolescent client who has a new prescription for Albuterol, PO. Which of the following instructions should the healthcare provider include?

• A. You should not use this medication for an acute asthma attack.'
• B. Tremors may be an adverse effect of this medication.'
• C. Long-term use of this medication can lead to hyperglycemia.'
• D. This medication can inhibit skeletal growth.'

Correct answer: B

Rationale: Tremors may occur as a result of excessive stimulation of beta2 receptors in skeletal muscles when using Albuterol. It is important to educate the parent about potential adverse effects to ensure proper monitoring and management of the adolescent client's medication regimen.

5. A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?

• A. Irregular heart rhythm
• B. Abnormal uterine bleeding
• C. Yellowing of the sclera or dark-colored urine
• D. Difficulty swallowing

Correct answer: B

Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.

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