Nursing Elites

1. A client has a new prescription for Verapamil to treat angina. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of Verapamil?

• A. I am frequently constipated.
• B. I have been urinating more frequently.
• C. My skin is peeling.
• D. I have ringing in my ears.

Correct answer: A

Rationale: The correct answer is A: 'I am frequently constipated.' Constipation is a common adverse effect of Verapamil, a calcium channel blocker. Verapamil can slow down intestinal motility, leading to constipation as a side effect. Choices B, C, and D are not typically associated with adverse effects of Verapamil. Increased urination is not a common side effect, skin peeling is not related to Verapamil use, and ringing in the ears is not a typical adverse effect of this medication.

2. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?

• A. Instruct the client to self-ambulate every 2 hours.
• B. Offer oral hygiene every 2 hours.
• C. Anticipate medication administration 2 hours prior to delivery.
• D. Monitor fetal heart rate every 2 hours.

Correct answer: B

Rationale: When a client is receiving IV Opioid analgesics during labor, the nurse should offer oral hygiene every 2 hours. Opioid analgesics can cause adverse effects like dry mouth, nausea, and vomiting. Providing oral hygiene care helps alleviate these symptoms and maintains the client's comfort and well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate during labor as mobility may be limited. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's needs and the progress of labor. Monitoring fetal heart rate every 2 hours is important during labor, but it is not specifically related to the client receiving IV Opioid analgesics.

3. A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?

• A. Use a blood pressure cuff to distend the veins.
• B. Select the antecubital area to insert the IV catheter.
• C. Distend the veins by using a blood pressure cuff.
• D. Direct the client to lower his arm below his heart.

Correct answer: C

Rationale: The correct answer is C. The healthcare professional should distend the veins using a blood pressure cuff to make the veins more visible and accessible for IV catheter insertion. This technique helps reduce the risk of overfilling the vein, which can lead to complications such as hematoma formation. Choices A, B, and D are incorrect because while selecting the antecubital area is often appropriate for IV insertion in adults, the key action in this scenario is to distend the veins using a blood pressure cuff to facilitate the procedure.

4. A client is starting therapy with topotecan. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of topotecan. Monitoring for signs of infection is crucial to prevent complications during therapy. Choices A, B, and D are less critical findings compared to a sore throat. Hair loss is a common side effect of chemotherapy, fatigue is expected with cancer treatment, and red urine is a known harmless effect of topotecan.

5. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV Nitroprusside is infused at high dosages, it can lead to thiocyanate toxicity, causing mental status changes such as delirium. It is crucial to monitor the thiocyanate levels to ensure they remain below 10 mg/dL during therapy to prevent adverse effects. Choices A, B, and D are incorrect because IV Nitroprusside is not commonly associated with intestinal ileus, neutropenia, or hyperthermia. Monitoring for delirium is crucial due to the risk of thiocyanate toxicity.

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