Nursing Elites

1. When teaching a client how to use nitroglycerin transdermal ointment for angina, which instruction should the nurse include?

• A. Remove the prior dose before applying a new dose.
• B. Rub the ointment directly into your skin until it is no longer visible.
• C. Cover the applied ointment with a clean gauze pad.
• D. Apply the ointment to the same skin area each time.

Correct answer: A

Rationale: The correct instruction is to remove the prior dose before applying a new dose. This helps prevent toxicity by ensuring the client does not inadvertently apply an excessive amount of nitroglycerin.

2. When reviewing a client's health record, a healthcare professional notes that the client is experiencing episodes of hypokalemia. Which of the following medications should be identified as a cause of the client's hypokalemia?

• A. Captopril
• B. Lisinopril
• C. Furosemide
• D. Spironolactone

Correct answer: C

Rationale: Furosemide, a loop diuretic, can lead to hypokalemia by increasing the excretion of potassium in the urine. This potassium loss can result in lower-than-normal levels of potassium in the body, leading to hypokalemia.

3. A client receiving chemotherapy reports nausea and vomiting. Which of the following medications should the nurse anticipate administering?

• A. Ondansetron
• B. Metoclopramide
• C. Promethazine
• D. Lorazepam

Correct answer: A

Rationale: The correct answer is A: Ondansetron. Ondansetron is a commonly used antiemetic for managing nausea and vomiting in clients undergoing chemotherapy. It works by blocking serotonin to reduce these symptoms effectively. Metoclopramide (choice B) is another antiemetic but is more commonly used for gastric motility disorders. Promethazine (choice C) is an antihistamine with antiemetic properties, but ondansetron is often preferred for chemotherapy-induced nausea and vomiting due to its efficacy and fewer side effects. Lorazepam (choice D) is a benzodiazepine used for anxiety and insomnia, not typically for managing nausea and vomiting in this context.

4. A client with Depression has a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)

• A. Cough
• B. Dizziness
• C. Decreased libido
• D. B and C

Correct answer: D

Rationale: The correct answer is D: 'B and C.' Venlafaxine, a medication used to treat depression, can lead to adverse effects like dizziness and decreased libido. It is important for the nurse to monitor the client for these potential side effects. Cough and alopecia are not typically associated with Venlafaxine. Therefore, choices A (Cough) and C (Decreased libido) are incorrect. Dizziness and decreased libido are the adverse effects that the nurse should focus on when monitoring a client on Venlafaxine treatment.

5. 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.

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