Nursing Elites

1. A healthcare professional is planning to administer Morphine IV to a postoperative client. Which of the following actions should the healthcare professional take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea that occurs with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action the healthcare professional should take when administering Morphine IV to a postoperative client is to withhold the medication if the respiratory rate is less than 12/min. Respiratory depression is a common adverse effect of opioids like Morphine. Administering opioids when the respiratory rate is already compromised can further depress breathing, leading to life-threatening complications. Monitoring for seizures and confusion (Choice A) is not directly related to Morphine administration. Protecting the client's skin from severe diarrhea (Choice B) is not a common side effect of morphine. Administering Morphine via IV bolus (Choice D) should be done carefully but is not the most critical action in this scenario.

2. When starting therapy with raloxifene, a client should monitor for which of the following adverse effects?

• A. Leg cramps
• B. Hot flashes
• C. Urinary frequency
• D. Hair loss

Correct answer: B

Rationale: The correct answer is B: Hot flashes. When initiating therapy with raloxifene, clients should be advised to monitor for hot flashes as they are a common adverse effect associated with this medication. Hot flashes are a well-known side effect of raloxifene due to its action on estrogen receptors. Leg cramps (Choice A), urinary frequency (Choice C), and hair loss (Choice D) are not typically associated with raloxifene therapy. Therefore, monitoring for hot flashes is crucial to manage and address this common side effect appropriately.

3. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: When taking colesevelam, it should be administered with food and at least 8 oz of water to ensure proper absorption and reduce the risk of gastrointestinal side effects. Taking colesevelam with food also helps in binding to bile acids efficiently. Options A, B, and C are incorrect because they do not provide the necessary instruction for taking colesevelam correctly or monitoring specific side effects associated with this medication.

4. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.

5. When teaching a client who has a new prescription for Ciprofloxacin, which of the following instructions should the nurse include?

• A. Take this medication with an antacid.
• B. Avoid direct sunlight.
• C. Increase your intake of dairy products.
• D. Expect urine to turn orange.

Correct answer: B

Rationale: The correct instruction for a client prescribed Ciprofloxacin is to avoid direct sunlight. Ciprofloxacin can cause photosensitivity, increasing the risk of sunburn. Clients should be advised to avoid direct sunlight and wear protective clothing, including hats and sunglasses when going outdoors to prevent skin damage. Choices A, C, and D are incorrect. Taking Ciprofloxacin with an antacid can reduce its absorption, so they should not be taken together. Increasing dairy product intake is not necessary or relevant to taking Ciprofloxacin. While Ciprofloxacin can discolor urine, turning it orange, this is not a critical side effect that requires specific instructions for the client.

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