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 has a new prescription for nitroglycerin. Which of the following adverse effects should the nurse instruct the client to report that can indicate the medication is effective?

• A. Headache
• B. Nausea
• C. Dizziness
• D. Dry mouth

Correct answer: A

Rationale: Headache is a common side effect of nitroglycerin due to its vasodilatory effects. It can indicate that the medication is working effectively by dilating blood vessels, improving blood flow, and reducing cardiac workload. Therefore, the client should report experiencing headaches as it may suggest the therapeutic action of nitroglycerin. Nausea, dizziness, and dry mouth are not typically associated with the therapeutic effects of nitroglycerin and should be reported as adverse effects that may necessitate medical attention.

3. A client has been prescribed Warfarin for atrial fibrillation. Which of the following instructions should the nurse include in the discharge teaching?

• A. Avoid foods high in vitamin K.
• B. Take this medication with food to prevent nausea.
• C. Monitor your heart rate daily before taking the medication.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for the nurse to include in the discharge teaching for a client prescribed Warfarin is to 'Avoid foods high in vitamin K.' Foods high in vitamin K can decrease the effectiveness of Warfarin by interfering with its anticoagulant effects, potentially leading to blood clotting issues. It is crucial for clients on Warfarin therapy to maintain a consistent intake of vitamin K-containing foods to ensure the stability of the medication's effects. Choices B, C, and D are incorrect because taking Warfarin with food, monitoring heart rate daily, or limiting fluid intake are not directly related to optimizing the effectiveness of Warfarin therapy.

4. A client has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the nurse perform first?

• A. Urine output
• B. Bowel sounds
• C. Pain level
• D. Respiratory rate

Correct answer: D

Rationale: The nurse should prioritize assessing the client's respiratory rate first when administering Morphine due to the risk of respiratory depression, which is a life-threatening adverse effect of this medication. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress early and take prompt action to ensure the client's safety. Assessing urine output, bowel sounds, and pain level are also important but not as critical as monitoring respiratory rate when initiating Morphine therapy.

5. A client who takes Chlorpromazine for the treatment of Schizophrenia is due for a follow-up assessment. The nurse should expect the greatest improvement in which of the following manifestations? (Select all that apply.)

• A. Disorganized speech.
• B. Bizarre behavior.
• C. Impaired social interactions.
• D. Hallucinations.

Correct answer: A

Rationale: When a client takes a conventional antipsychotic medication like chlorpromazine, the greatest improvement is typically seen in positive symptoms such as disorganized speech. These medications are more effective in managing positive symptoms like disorganized speech rather than negative symptoms like impaired social interactions or hallucinations. Therefore, the nurse should anticipate improvement in disorganized speech as a positive response to chlorpromazine treatment.

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