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 caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

3. A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?

• A. Stop the infusion.
• B. Call the provider.
• C. Elevate the head of the bed.
• D. Auscultate breath sounds.

Correct answer: A

Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.

4. A client has a new prescription for Lisinopril. Which of the following adverse effects should the nurse monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: The correct answer is 'A: Dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. If the client experiences this side effect, it is important to notify the healthcare provider for assessment and possible medication adjustment.

5. When teaching a client about a new prescription for Celecoxib, which of the following information should the nurse include?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The nurse should educate the client that taking Celecoxib increases the risk of a myocardial infarction due to its suppression of vasodilation. Celecoxib belongs to the class of NSAIDs known to have cardiovascular risks, including an increased risk of heart attacks. Choice B is incorrect because Celecoxib does not decrease the risk of stroke. Choice C is incorrect because Celecoxib selectively inhibits COX-2 rather than COX-1. Choice D is incorrect because Celecoxib does not increase platelet aggregation; in fact, it inhibits platelet aggregation.

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