Nursing Elites

1. A healthcare professional is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis Gravidarum. The healthcare professional should clarify which of the following parts of the prescription with the provider?

• A. Name
• B. Dosage
• C. Route
• D. Frequency

Correct answer: D

Rationale: The prescription lacks the frequency of medication administration, which is crucial for ensuring appropriate use. In this case, the frequency of when the medication can be taken needs to be clarified with the provider to provide safe and effective care for the client with Hyperemesis Gravidarum.

2. How should a client prevent systemic absorption of Timolol eye drops according to the nurse's instructions?

• A. Bony orbit
• B. Nasolacrimal duct
• C. Conjunctival sac
• D. Outer canthus

Correct answer: B

Rationale: The correct technique to prevent systemic absorption of eye drops is to press on the nasolacrimal duct while instilling them. By doing so, the lacrimal punctum gets temporarily blocked, reducing drainage into the nasolacrimal duct and systemic circulation. This method helps enhance the localized effect of the medication and decreases the risk of systemic side effects. Choices A, C, and D are incorrect as they do not play a direct role in preventing systemic absorption of the eye drops.

3. A healthcare professional is preparing to administer morphine 4 mg IV to a client. Available is morphine 10 mg/mL. How many mL should the healthcare professional administer?

• A. 0.2 mL
• B. 0.4 mL
• C. 0.6 mL
• D. 0.8 mL

Correct answer: B

Rationale: To administer 4 mg from a solution of 10 mg/mL, the healthcare professional should administer 0.4 mL. The calculation is done by dividing the desired dose (4 mg) by the concentration of the solution (10 mg/mL), which equals 0.4 mL. Choice A (0.2 mL) is incorrect because it is half of the correct calculation. Choice C (0.6 mL) is incorrect because it is 50% more than the correct calculation. Choice D (0.8 mL) is incorrect because it exceeds the correct calculation.

4. A nurse is caring for a client with hypertension who asks about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients with a history of which of the following conditions?

• A. Asthma
• B. Glaucoma
• C. Depression
• D. Migraines

Correct answer: A

Rationale: Corrected Rationale: Propranolol is contraindicated in clients with a history of asthma because it can cause bronchospasms due to its non-selective beta-blocking properties. By blocking beta-2 receptors in the lungs, propranolol can lead to bronchoconstriction, potentially triggering asthma symptoms and exacerbating respiratory issues. Asthma patients should avoid medications like propranolol that can worsen their condition. Choices B, C, and D are incorrect as propranolol is not contraindicated in clients with glaucoma, depression, or migraines. In fact, propranolol is sometimes used in the treatment of migraines and certain types of glaucoma.

5. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.

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