Nursing Elites

1. A client has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching?

• A. You should have a high-carbohydrate snack between meals and at bedtime.
• B. You are likely to develop hand tremors if you take this medication for a long period of time.
• C. You may experience temporary numbness of your mouth after each dose.
• D. You should have your white blood cell count monitored every week.

Correct answer: D

Rationale: Clozapine carries a risk for fatal agranulocytosis. To monitor for this serious adverse effect, it is crucial to check the client's white blood cell count weekly while they are on clozapine therapy.

2. A client has a prescription for long-term use of oral prednisone for the treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: The correct answer is weight gain. Oral prednisone can lead to weight gain and fluid retention due to its sodium and water retention effects. Monitoring weight changes is crucial to identify and manage this adverse effect. Choices B, C, and D are incorrect because oral prednisone is not typically associated with nervousness, bradycardia, or constipation as common adverse effects. Therefore, the nurse should primarily focus on monitoring weight gain in clients prescribed long-term oral prednisone therapy.

3. A healthcare professional reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the professional take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication, and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify trough levels of a medication, the healthcare professional should obtain a blood specimen immediately before administering the next dose of medication. This timing ensures an accurate representation of the medication's lowest concentration in the bloodstream, which is crucial for therapeutic monitoring and dose adjustments. Choice B is incorrect because waiting 24 hours after taking the medication would not provide an accurate trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect because obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level, as it is the lowest concentration before the next dose.

4. A client is receiving moderate sedation with Diazepam IV and is oversedated. Which of the following medications should the nurse anticipate administering to this client?

• A. Ketamine
• B. Naltrexone
• C. Flumazenil
• D. Fluvoxamine

Correct answer: C

Rationale: Flumazenil is a specific benzodiazepine antagonist that competitively reverses the sedative effects of benzodiazepines like Diazepam. In cases of oversedation or respiratory depression caused by benzodiazepines, administering Flumazenil can help reverse the effects and restore the client's consciousness and respiratory drive. Ketamine (Choice A) is a dissociative anesthetic and not used to reverse benzodiazepine sedation. Naltrexone (Choice B) is an opioid receptor antagonist and not indicated for benzodiazepine oversedation. Fluvoxamine (Choice D) is an antidepressant and not used to counteract benzodiazepine sedation.

5. A client in an acute mental health facility is experiencing withdrawal from Opioid use and has a new prescription for Clonidine. Which of the following actions should the nurse identify as the priority?

• A. Administer the clonidine on the prescribed schedule.
• B. Provide ice chips at the client's bedside.
• C. Educate the client on the effects of clonidine.
• D. Obtain baseline vital signs.

Correct answer: D

Rationale: In this scenario, the priority action for the nurse is to obtain baseline vital signs. This step is crucial in assessing the client's current physiological status and establishing a reference point for monitoring the effects of Clonidine. Administering the medication, providing ice chips, and educating the client are important tasks but assessing the client's vital signs takes precedence to ensure the client's safety and well-being during withdrawal management.

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