Nursing Elites

1. When a client is starting long-term oral prednisone for chronic asthma, what adverse effect should the nurse instruct the client to monitor for?

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

Correct answer: A

Rationale: Weight gain is a common adverse effect of oral prednisone due to sodium and water retention, which can lead to fluid retention. Monitoring weight changes is important as it helps in early identification of this adverse effect, enabling timely interventions to manage it. Choice B, nervousness, is not typically associated with oral prednisone use. Bradycardia (Choice C) is unlikely as prednisone usually causes tachycardia or increased heart rate. Constipation (Choice D) is not a common adverse effect of prednisone compared to weight gain.

2. A healthcare provider is assessing a client who takes Lithium Carbonate for the treatment of Bipolar disorder. The provider should recognize which of the following findings as a possible indication of toxicity to this medication?

• A. Severe hypertension
• B. Coarse tremors
• C. Constipation
• D. Muscle spasm

Correct answer: B

Rationale: Coarse tremors are a common sign of Lithium toxicity. It is important for healthcare providers to monitor for this symptom as it indicates a potential overdose of the medication. Severe hypertension, constipation, and muscle spasms are not typically associated with Lithium toxicity. Severe hypertension is not a common sign of Lithium toxicity but rather a symptom of hypertensive crisis. Constipation is not a typical sign of Lithium toxicity but could be seen in other conditions. Muscle spasms are not specific to Lithium toxicity but can occur due to various reasons.

3. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.

4. A healthcare provider plans to administer Morphine IV to a postoperative client. Which of the following actions should the provider take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea associated with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action for the provider is to withhold morphine if the client's respiratory rate is 12/min or less. Respiratory depression is a serious side effect of morphine and other opioids. Withholding the medication and informing the healthcare provider is essential to prevent further respiratory compromise in the client. Choices A, B, and D are incorrect because monitoring for seizures and confusion, protecting the client's skin from severe diarrhea, and administering morphine via IV bolus over 30 seconds or less are not the primary actions to ensure client safety when administering morphine IV. Respiratory status is crucial due to the risk of respiratory depression associated with opioid administration.

5. A healthcare professional is preparing to administer an IV antibiotic to a client who has a systemic infection. Which of the following actions should the professional take first?

• A. Administer an antihistamine prior to the antibiotic.
• B. Monitor the client's urine output.
• C. Check the client's allergy history.
• D. Assess the client's vital signs.

Correct answer: C

Rationale: The first action the healthcare professional should take is to check the client's allergy history before administering the antibiotic to prevent a potential allergic reaction. It is crucial to identify any known allergies to antibiotics to ensure the client's safety and well-being. Administering an antihistamine prior to the antibiotic (Choice A) is not recommended unless an allergic reaction occurs. Monitoring the client's urine output (Choice B) and assessing the client's vital signs (Choice D) are important but not the first step in this situation. Checking the client's allergy history takes precedence to prevent adverse reactions.

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