Nursing Elites

1. A healthcare professional is preparing to administer Butorphanol to a client who has a history of substance use disorder. The healthcare professional should identify which of the following information as true regarding Butorphanol?

• A. Butorphanol has a lower risk of abuse than morphine.
• B. Butorphanol causes a lower incidence of respiratory depression than morphine.
• C. Butorphanol can be reversed with an opioid antagonist.
• D. Butorphanol can cause abstinence syndrome in opioid-dependent clients.

Correct answer: D

Rationale: The correct answer is D. Butorphanol is an opioid agonist/antagonist that can precipitate withdrawal symptoms in opioid-dependent individuals. Symptoms of abstinence syndrome can include abdominal pain, fever, and anxiety. This occurs because butorphanol competes with and displaces opioid agonists from receptors, leading to withdrawal symptoms in opioid-dependent clients. Choices A, B, and C are incorrect. Butorphanol does not have a lower risk of abuse than morphine, it can cause respiratory depression similar to other opioids, and although it is an opioid antagonist, it does not get reversed by opioid antagonists.

2. A client is starting a course of Metronidazole to treat an infection. For which of the following adverse effects should the client stop taking Metronidazole and notify the provider?

• A. Metallic taste
• B. Nausea
• C. Ataxia
• D. Dark-colored urine

Correct answer: C

Rationale: The correct answer is C, 'Ataxia.' Ataxia is a sign of central nervous system (CNS) toxicity, which can be a severe adverse effect of Metronidazole. Metallic taste and nausea are common side effects of Metronidazole but do not require stopping the medication unless they persist or worsen. Dark-colored urine is not typically associated with Metronidazole and does not indicate a severe adverse effect.

3. A client has a prescription for ceftriaxone. Which of the following information should the nurse include in the teaching?

• A. You may develop a cough while taking this medication.
• B. You should stop taking this medication if you develop a rash.
• C. This medication can be given orally.
• D. This medication may cause your urine to turn yellow.

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to discontinue ceftriaxone if a rash develops, as it could indicate an allergic reaction that needs to be reported to the healthcare provider for further evaluation and management. Choices A, C, and D are incorrect because cough development, oral administration, and yellow urine are not typically associated with ceftriaxone use and are not critical information that the nurse needs to emphasize in this scenario.

4. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.

5. What should you monitor when administering Clopidogrel to a patient?

• A. Signs of thrombotic thrombocytopenic purpura
• B. Bleeding during therapy
• C. CBC with differential and platelet count
• D. All of the above

Correct answer: D

Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.

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