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 prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients experiencing tachycardia, including those with reflex tachycardia induced by medications like Isosorbide Mononitrate. Furosemide (Choice A) is a diuretic and is not indicated for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor used for hypertension and heart failure, not tachycardia. Ranolazine (Choice C) is used in chronic angina but does not address tachycardia.

3. A client asks a nurse about Feverfew. Which response should the nurse provide?

• A. It is used to treat skin infections.
• B. It can decrease the frequency of migraine headaches.
• C. It can lessen the nasal congestion in the common cold.
• D. It can relieve nausea of morning sickness during pregnancy.

Correct answer: B

Rationale: The correct response is B: 'It can decrease the frequency of migraine headaches.' Feverfew is known for reducing the frequency of migraine headaches, but it has not been proven to relieve an existing migraine headache. Choices A, C, and D are incorrect because Feverfew is not used to treat skin infections, lessen nasal congestion in the common cold, or relieve nausea of morning sickness during pregnancy.

4. 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.

5. A client has a new prescription for Pancrelipase. Which of the following instructions should the nurse include?

• A. Take the medication with meals and snacks.
• B. Expect your urine to turn orange.
• C. Increase your intake of high-calcium foods.
• D. Avoid consuming dairy products.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication with meals and snacks.' Pancrelipase should be taken with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This timing ensures that the medication functions optimally by assisting in the digestion process when food is present in the gastrointestinal system. Choice B is incorrect because urine discoloration is not a common side effect of Pancrelipase. Choice C is incorrect as there is no specific need to increase high-calcium foods with Pancrelipase. Choice D is also incorrect as avoiding dairy products is not necessary when taking Pancrelipase.

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