Nursing Elites

1. A hospitalized client receiving IV heparin for a deep-vein thrombosis begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

• A. Vitamin K1
• B. Atropine
• C. Protamine
• D. Calcium gluconate

Correct answer: C

Rationale: In this scenario, the client is experiencing a serious complication of heparin therapy, likely due to heparin-induced thrombocytopenia. Protamine is the antidote for heparin and can reverse its anticoagulant effects. It is essential to administer protamine promptly to counteract the effects of heparin and manage the bleeding. Vitamin K1 is used to reverse the effects of warfarin, not heparin. Atropine is used to treat bradycardia or some types of poisoning. Calcium gluconate is used to manage hyperkalemia or calcium channel blocker toxicity, not to reverse heparin's effects.

2. A healthcare provider is planning care for a client with brain cancer experiencing headaches. Which of the following adjuvant medications is indicated for this client?

• A. Dexamethasone
• B. Methylphenidate
• C. Hydroxyzine
• D. Amitriptyline

Correct answer: A

Rationale: Dexamethasone, a glucocorticoid, is indicated for clients with brain cancer experiencing headaches as it decreases inflammation and swelling. It is commonly used to reduce cerebral edema and relieve pressure caused by the tumor. Methylphenidate (Choice B) is a central nervous system stimulant used in conditions like ADHD and narcolepsy, not for brain cancer headaches. Hydroxyzine (Choice C) is an antihistamine used for anxiety and allergic conditions, not indicated for brain cancer headaches. Amitriptyline (Choice D) is a tricyclic antidepressant used for depression, neuropathic pain, and migraine prophylaxis, but not typically indicated for brain cancer headaches.

3. ACE Inhibitors are used in the treatment of all EXCEPT:

• A. Hypertension
• B. Heart Failure
• C. Hypotension
• D. Diabetic nephropathy

Correct answer: C

Rationale: ACE inhibitors are commonly used in the treatment of hypertension, heart failure, and diabetic nephropathy due to their ability to reduce blood pressure, improve heart function, and protect the kidneys. However, they are not indicated for hypotension as they can further lower blood pressure, worsening the condition. Therefore, the correct answer is C. Choice A, hypertension, is correct as ACE inhibitors are a first-line treatment for this condition. Choice B, heart failure, is also correct as ACE inhibitors help improve heart function in patients with heart failure. Choice D, diabetic nephropathy, is correct as ACE inhibitors can slow the progression of kidney damage in diabetic patients.

4. A client has a prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take furosemide in the morning.
• B. Eat a diet high in potassium.
• C. Avoid foods high in magnesium.
• D. Limit fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct instruction for a client taking furosemide is to eat a diet high in potassium. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Consuming foods rich in potassium can help maintain normal potassium levels in the body and counteract the potential side effect of furosemide. Choices A, C, and D are incorrect because taking furosemide in the morning does not specifically relate to its effectiveness or side effects, avoiding foods high in magnesium is not a primary concern when taking furosemide, and limiting fluid intake to 1 liter per day is not a general recommendation for individuals taking furosemide.

5. A healthcare professional is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the healthcare professional administer per dose?

• A. 0.8 mL
• B. 0.75 mL
• C. 0.5 mL
• D. 1 mL

Correct answer: A

Rationale: To calculate the volume to administer, use the formula: (Desired dose / Concentration) = Volume to administer. In this case, (15,000 units / 20,000 units/mL) = 0.75 mL, which is rounded up to 0.8 mL. Therefore, the healthcare professional should administer 0.8 mL per dose of heparin. Choice B (0.75 mL) is incorrect as it is the exact calculated volume but needs to be rounded up. Choices C (0.5 mL) and D (1 mL) are incorrect as they do not reflect the correct calculated volume for the desired dose of heparin.

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