Nursing Elites

1. A client is being taught by a healthcare professional about preventing Otitis Externa. Which of the following instructions should the healthcare professional include?

• A. Clean the ear with a cotton-tipped swab daily
• B. Place earplugs in the ears when sleeping at night
• C. Use a cool water irrigation solution to remove earwax
• D. Tip the head to the side to remove water from the ears after showering

Correct answer: D

Rationale: To prevent Otitis Externa, it is important to remove water from the ears after showering or swimming. This helps reduce the risk of moisture buildup in the ear canal, which can lead to infection. Cleaning the ear with a cotton-tipped swab daily can actually increase the risk of injury or infection. Placing earplugs in the ears when sleeping at night may trap moisture and promote bacterial growth. Using a cool water irrigation solution to remove earwax is not recommended as it can disrupt the natural balance of the ear canal.

2. A client is being discharged with a new prescription for Clopidogrel. Which of the following instructions should the nurse include?

• A. Avoid taking aspirin while on this medication.
• B. Take this medication with food.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client prescribed Clopidogrel is to avoid taking aspirin while on this medication. Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs can potentiate the risk of bleeding, so they should be avoided while taking Clopidogrel to prevent adverse effects. Choices B, C, and D are incorrect because Clopidogrel does not need to be taken with food, there is no specific dietary restriction related to potassium, and the timing of administration (bedtime) is not a critical instruction for this medication.

3. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypertension
• C. Bone marrow suppression
• D. Constipation

Correct answer: C

Rationale: The correct answer is bone marrow suppression (Choice C). Methotrexate can lead to bone marrow suppression, resulting in adverse effects such as anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is essential to prevent complications and adjust treatment as needed. Choices A, B, and D are incorrect. Insomnia, hypertension, and constipation are not typically associated with methotrexate use in the treatment of Rheumatoid Arthritis.

4. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Monitor for signs of hyperglycemia.
• C. Avoid drinking grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct instruction for a client prescribed Verapamil is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication. This can result in a higher risk of adverse effects, such as hypotension and bradycardia. Therefore, it is essential for the client to avoid grapefruit juice while taking Verapamil to prevent potential complications. Choices A, B, and D are incorrect because taking Verapamil at bedtime, monitoring for signs of hyperglycemia, and increasing potassium-rich foods intake are not specific instructions related to Verapamil therapy and do not address the potential interaction with grapefruit juice.

5. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and is experiencing muscle weakness. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers by increasing acetylcholine levels at the neuromuscular junction, thereby helping to restore muscle strength. Naloxone is an opioid antagonist used to reverse opioid effects, not neuromuscular blockade. Dantrolene is a skeletal muscle relaxant used to treat malignant hyperthermia or neuroleptic malignant syndrome, not to reverse neuromuscular blockade. Vecuronium is a nondepolarizing neuromuscular blocking agent, like the one the client received, and is not used to reverse its effects.

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