Nursing Elites

1. A toddler is being admitted to the hospital after an Acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this patient?

• A. Acetylcysteine
• B. Pegfilgrastim
• C. Misoprostol
• D. Naltrexone

Correct answer: A

Rationale: In cases of Acetaminophen overdose, acetylcysteine is the antidote of choice. Acetylcysteine helps prevent liver damage by replenishing depleted glutathione levels, which is essential for detoxifying acetaminophen metabolites. Pegfilgrastim is a medication used to stimulate white blood cell production, Misoprostol is a medication for preventing stomach ulcers, and Naltrexone is used for treating opioid addiction and alcoholism, but none of these are indicated for Acetaminophen overdose.

2. A healthcare provider is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare provider should monitor the client for which of the following as an adverse effect of this medication?

• A. Bradycardia
• B. Hyperkalemia
• C. Hypoglycemia
• D. Hypocalcemia

Correct answer: B

Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, leading to potassium retention. Monitoring potassium levels is essential to prevent complications associated with hyperkalemia. Bradycardia (Choice A) is not a common adverse effect of Enalapril. Enalapril does not typically affect glucose levels, so hypoglycemia (Choice C) is not a common concern with this medication. Enalapril does not directly impact calcium levels, so hypocalcemia (Choice D) is not a typical adverse effect.

3. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.

4. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a different site each day.
• B. Remove the patch at bedtime each day.
• C. Apply the patch over an area with little or no hair.
• D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to remove it each day, usually at bedtime, to prevent tolerance. Keeping the patch on for 24 hours at a time can lead to tolerance development. Applying the patch to a different site each day is not necessary, as long as the area is rotated to prevent skin irritation. Applying the patch over an area with little or no hair is not a critical instruction for the Nitroglycerin patch.

5. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

• A. Contact the provider if the heart rate is less than 60/min.
• B. Check the pulse rate for 30 seconds and multiply the result by 2.
• C. Increase the intake of sodium.
• D. Take with food if nausea occurs.

Correct answer: A

Rationale: The correct answer is A. It is crucial for clients on Digoxin to monitor their heart rate. A heart rate less than 60/min can indicate bradycardia, a potential side effect of Digoxin. Therefore, the client should be instructed to contact the provider if their heart rate is less than 60/min to prevent complications and receive appropriate management. Choices B, C, and D are incorrect. Checking the pulse rate for 30 seconds and multiplying by 2 is not specific to Digoxin administration. Increasing sodium intake is contraindicated as Digoxin can lead to sodium retention. Taking Digoxin with food if nausea occurs is not recommended as it may affect the drug's absorption.

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