Nursing Elites

1. A nurse is providing discharge instructions to a client who has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a hairy area.
• B. Change the patch every 24 hours.
• C. Avoid exposure to heat sources.
• D. Cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction that the nurse should include when providing discharge instructions for a client with a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, leading to a risk of overdose. Choice A is incorrect because the patch should be applied to a clean, non-hairy area. Choice B is incorrect as the Fentanyl patch is usually changed every 72 hours, not every 24 hours. Choice D is incorrect as the patch should never be cut to adjust the dosage.

2. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function and potential worsening heart failure. This finding should be reported promptly to the provider for further evaluation and management to prevent complications. Weight loss, while significant, may be expected with diuretic use. A blood pressure of 104/60 mm Hg is within normal range and can be managed. A potassium level of 3.5 mEq/L is slightly low but not an immediate concern.

3. When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?

• A. “Your chest pain should go away with one tablet.”
• B. “If your chest pain doesn’t go away after three tablets, call 911; you might be having a heart attack.”
• C. “If your chest pain doesn’t go away with one tablet, you can repeat the dose as many times as you need to.”
• D. “Be sure to call 911 before you take any tablets.”

Correct answer: B

Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.

4. A healthcare provider is preparing to administer metoprolol to a client. Which of the following findings should the provider identify as a contraindication to receiving this medication?

• A. Bradycardia
• B. Hypertension
• C. Fever
• D. Rash

Correct answer: A

Rationale: Metoprolol, a beta-blocker, is contraindicated in clients with bradycardia as it can further lower the heart rate, potentially leading to more serious complications. Bradycardia is defined as a heart rate below 60 beats per minute, and administering metoprolol in such cases can exacerbate this condition, causing adverse effects on cardiac output. Hypertension, fever, and rash are not contraindications for metoprolol administration.

5. During an admission assessment for a client with severe Aspirin toxicity, which finding should the nurse expect?

• A. Body temperature 35°C (95°F)
• B. Lung crackles
• C. Cool, dry skin
• D. Respiratory depression

Correct answer: D

Rationale: In severe Aspirin toxicity, respiratory depression is an anticipated finding due to the development of respiratory acidosis. Aspirin toxicity can lead to metabolic acidosis, causing the individual to hyperventilate initially to compensate. However, as the condition progresses, respiratory depression can occur, resulting in impaired gas exchange and respiratory acidosis.

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