Nursing Elites

1. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?

• A. Inspect the skin for redness and irritation around the injection site.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to lie down for 30 minutes after oral administration.
• D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.

Correct answer: B

Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.

2. 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.

3. A client has been on levothyroxine therapy for several months. Which of the following findings indicates a therapeutic response to the medication?

• A. Decrease in level of thyroxine (T4)
• B. Increase in weight
• C. Increase in hours of sleep per night
• D. Decrease in level of thyroid stimulating hormone (TSH)

Correct answer: D

Rationale: A therapeutic response to levothyroxine is indicated by a decrease in the level of TSH. This decrease signifies that the body requires less stimulation to produce thyroid hormone, reflecting a normalization of thyroid function due to the medication's effectiveness. Choices A, B, and C are incorrect as an increase in T4 levels, weight gain, and increased sleep hours are not indicative of a therapeutic response to levothyroxine therapy.

4. A client with Atrial Fibrillation is prescribed Dabigatran to prevent Thrombosis. Which medication is prescribed concurrently to treat an adverse effect of Dabigatran?

• A. Vitamin K1
• B. Protamine
• C. Omeprazole
• D. Probenecid

Correct answer: C

Rationale: Omeprazole, a proton pump inhibitor, is prescribed for clients taking dabigatran who experience abdominal pain and other gastrointestinal adverse effects associated with dabigatran use. Proton pump inhibitors help manage these symptoms effectively. Choice A, Vitamin K1, is incorrect as it antagonizes the activity of Dabigatran, counteracting its anticoagulant effect. Choice B, Protamine, is used to reverse the anticoagulant effects of heparin, not dabigatran. Choice D, Probenecid, is not typically used to treat adverse effects of dabigatran.

5. A client has a prescription for Prednisone for the treatment of Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will increase my intake of potassium-rich foods.
• B. I should take my medication with food.
• C. I will decrease my intake of calcium-rich foods.
• D. I should avoid eating grapefruit while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Prednisone can cause hypokalemia, leading to low potassium levels. Increasing the intake of potassium-rich foods helps prevent this imbalance. Choices B, C, and D are incorrect because taking Prednisone with food, decreasing calcium-rich foods, or avoiding grapefruit are not specifically related to addressing the side effect of hypokalemia associated with Prednisone.

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