Nursing Elites

1. A client received IV Verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98/min, and blood pressure is 74/44 mm Hg. The nurse should anticipate a prescription for which of the following IV medications?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Magnesium sulfate

Correct answer: A

Rationale: In this situation, where the client's blood pressure is significantly lowered due to Verapamil administration, the nurse should anticipate a prescription for Calcium gluconate. Calcium gluconate is used to reverse severe hypotension caused by Verapamil. It should be given slowly intravenously as it counteracts the vasodilation caused by Verapamil, helping to normalize blood pressure levels. Sodium bicarbonate is not indicated for low blood pressure. Potassium chloride and magnesium sulfate are not the appropriate choices to address hypotension caused by Verapamil.

2. To which pharmacologic classification does the drug propranolol belong?

• A. Beta Blockers
• B. Cholinergics
• C. Immune globulins
• D. Barbiturates

Correct answer: A

Rationale: Propranolol belongs to the pharmacologic classification of Beta Blockers. Beta blockers work by blocking the action of adrenaline and other stress hormones on beta-adrenergic receptors. They are commonly used to manage conditions like high blood pressure, angina, and arrhythmias. Choice B, Cholinergics, is incorrect because cholinergics work by stimulating the parasympathetic nervous system, unlike beta blockers that block adrenergic receptors. Choice C, Immune globulins, is incorrect as it refers to antibodies used to boost the immune system, not the mechanism of action of propranolol. Choice D, Barbiturates, is incorrect as barbiturates are a different class of drugs that act as central nervous system depressants, primarily used as sedatives and anesthetics.

3. A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

4. A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?

• A. Cefaclor
• B. Cefazolin
• C. Cefepime
• D. Cephalexin

Correct answer: C

Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.

5. A client asks the nurse how Rituximab works, which the client is receiving to treat Non-Hodgkin's Leukemia. Which of the following should the nurse include?

• A. Blocks hormone receptors
• B. Increases immune response
• C. Binds with specific antigens on tumor cells
• D. Stops DNA replication during cell division

Correct answer: C

Rationale: Rituximab is a monoclonal antibody that binds with specific antigens on B-lymphocytes, leading to the destruction of cancer cells. In the context of Non-Hodgkin's Leukemia, Rituximab targets and destroys cancerous B-lymphocytes, which helps in treating the disease. Choices A, B, and D are incorrect. Rituximab does not block hormone receptors, increase immune response, or stop DNA replication during cell division. The primary mode of action of Rituximab is its binding with specific antigens on tumor cells, specifically B-lymphocytes, to elicit an immune response against cancerous cells.

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