Nursing Elites

1. A client who is withdrawing from alcohol has been prescribed Propranolol. Which information should the nurse include in the teaching?

• A. Increases the risk for seizure activity.
• B. Provides a form of aversion therapy.
• C. Decreases cravings.
• D. Results in mild hypertension.

Correct answer: C

Rationale: The correct information the nurse should include in the teaching is that Propranolol decreases cravings for alcohol. Propranolol is used as an adjunct medication during alcohol withdrawal to help reduce the desire for alcohol. Choice A is incorrect as Propranolol does not increase the risk for seizure activity; it can actually be used to prevent alcohol withdrawal seizures. Choice B is also incorrect as Propranolol does not provide aversion therapy. Choice D is incorrect as Propranolol is not known to result in mild hypertension.

2. When starting therapy with cisplatin, a client should report which of the following adverse effects as instructed by the nurse?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The nurse should instruct the client to report tinnitus because it can be an indication of ototoxicity, a potential adverse effect of cisplatin. Ototoxicity can manifest as tinnitus, hearing loss, or balance disturbances, so it is crucial for the client to promptly report any changes in hearing such as tinnitus to prevent further damage.

3. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. To ensure the insulin is available when food is digested, the client should take this medication 30 minutes before each meal. This timing aligns the medication with the expected postprandial rise in blood glucose levels, optimizing its effectiveness in controlling blood sugar levels. Choices A, C, and D are incorrect because taking Repaglinide with meals, just before bed, or as soon as waking up does not align with the medication's mechanism of action and timing needed for optimal effectiveness.

4. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.

5. A healthcare professional is preparing to administer a transfusion of 300 mL of pooled platelets for a client with severe Thrombocytopenia. How should the healthcare professional plan to administer the transfusion over which of the following time frames?

• A. Within 30 minutes/unit
• B. Within 60 minutes/unit
• C. Within 2 hours/unit
• D. Within 4 hours/unit

Correct answer: A

Rationale: Platelets are fragile components that must be administered promptly to minimize the risk of clumping. The correct administration time for platelets is within 15 to 30 minutes per unit to maintain their therapeutic effectiveness and reduce adverse effects. Administering platelets over longer time frames can lead to decreased efficacy and potential harm to the patient. Therefore, the correct answer is to administer the 300 mL of pooled platelets within 30 minutes per unit.

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