Nursing Elites

1. A client is admitted for a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine is known to produce psychological effects, such as hallucinations. Therefore, individuals with schizophrenia are at increased risk of experiencing exacerbation of their symptoms if given Ketamine, making it a contraindication for its use as an intravenous anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for Ketamine use as an intravenous anesthetic.

2. A client has been prescribed diltiazem (Cardizem) and asks the nurse what type of drug this is. Which response by the nurse is most appropriate?

• A. “A beta blocker.”
• B. “A sodium channel blocker.”
• C. “An alpha blocker.”
• D. “A calcium channel blocker.”

Correct answer: D

Rationale: Diltiazem (Cardizem) belongs to the class of drugs known as calcium channel blockers. These medications work by blocking calcium from entering the muscle cells of the heart and blood vessels, leading to relaxation of the blood vessels and reduced workload on the heart. This helps in lowering blood pressure and improving blood flow. It is crucial for the nurse to provide accurate information to the client about the type of drug prescribed to ensure understanding and compliance with the treatment plan.

3. A client with breast cancer is receiving cyclophosphamide. What finding should the nurse monitor for?

• A. Hypertension
• B. Hyperglycemia
• C. Ototoxicity
• D. Hemorrhagic cystitis

Correct answer: D

Rationale: When a client is receiving cyclophosphamide, the nurse should monitor for hemorrhagic cystitis, a severe adverse effect caused by bladder irritation. It is essential to watch for signs such as hematuria, dysuria, and urinary frequency, and promptly intervene to prevent further complications. Hypertension (Choice A) is not typically associated with cyclophosphamide use. Hyperglycemia (Choice B) is not a common side effect of cyclophosphamide. Ototoxicity (Choice C) is more commonly associated with medications like aminoglycoside antibiotics or high-dose aspirin.

4. A healthcare professional in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the healthcare professional administer safely to this client?

• A. Varicella vaccine
• B. Rubella vaccine
• C. Inactivated influenza vaccine
• D. Measles vaccine

Correct answer: C

Rationale: The correct answer is C, the inactivated influenza vaccine. During pregnancy, the Centers for Disease Control and Prevention (CDC) recommend the inactivated influenza vaccine as safe for pregnant individuals. This vaccination is crucial to protect both the pregnant person and their developing baby from influenza-related complications. It is essential to avoid live vaccines, such as varicella (chickenpox), rubella, and measles vaccines during pregnancy due to the theoretical risk of harm to the fetus. Choices A, B, and D are incorrect because live vaccines are generally contraindicated during pregnancy.

5. 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.

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