Nursing Elites

1. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of a transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously. Injection-site redness and swelling are common adverse effects. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for any potential issues or reactions.

2. A client has a new prescription for Captopril to treat hypertension. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Avoid salt substitutes.
• C. Increase your intake of potassium-rich foods.
• D. Expect a dry cough to develop.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to advise the client to avoid salt substitutes. Salt substitutes often contain potassium, and captopril can cause hyperkalemia. By avoiding salt substitutes, the client can prevent elevated potassium levels and associated complications.

3. What does it mean when a medication has a half-life?

• A. It only lasts for 30 minutes after the medication is given
• B. How long it takes for half of the dose to be eliminated from the bloodstream
• C. It is the peak of how effective the medicine is
• D. Drug is greatly reduced before it reaches the systemic circulation

Correct answer: B

Rationale: When a medication has a half-life, it refers to the time it takes for half of the dose to be eliminated from the bloodstream. This parameter is crucial in understanding the duration of action and dosing intervals for medications in clinical practice. Choice A is incorrect as the half-life is not about how long the medication lasts but about elimination from the body. Choice C is incorrect because the half-life is not about the peak effectiveness of the medicine. Choice D is incorrect as it does not accurately define the concept of half-life.

4. A client is being discharged with a new prescription for Atenolol. Which of the following instructions should the nurse include?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid consuming foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B: 'Monitor your heart rate regularly.' Atenolol is a beta-blocker that can cause bradycardia (slow heart rate). Monitoring the heart rate regularly is crucial to promptly detect any significant decreases. This allows for timely intervention and adjustment of the medication regimen if needed, helping to prevent adverse effects associated with bradycardia. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning does not address the need for heart rate monitoring. Avoiding foods high in potassium is more relevant for medications like ACE inhibitors or potassium-sparing diuretics. Increasing fluid intake is not directly related to the use of Atenolol.

5. A healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?

• A. Warfarin
• B. Acetaminophen
• C. Ibuprofen
• D. Aspirin

Correct answer: D

Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.

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