Nursing Elites

1. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

2. A client has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

• A. I will clean the site with an alcohol swab before applying the patch.
• B. I will rotate the application sites weekly.
• C. I will apply the patch to an area of skin with no hair.
• D. I will place the new patch where the old patch was.

Correct answer: C

Rationale: The correct answer is C because applying the patch to an area of skin without hair ensures better absorption of the medication. Hair can interfere with the patch's adherence and effectiveness. It is important for the client to choose a clean, hairless area for proper medication delivery. Choices A, B, and D are incorrect. Cleaning the site with an alcohol swab is a good practice but does not specifically indicate understanding of proper patch application. Rotating application sites weekly is important to prevent skin irritation but is not directly related to applying the patch to an area of skin without hair. Placing the new patch where the old patch was may lead to skin irritation and poor absorption of the medication.

3. Which of the following drugs is associated with the reaction of tendon dysfunction?

• A. Digitalis
• B. Niacin
• C. Tetracycline
• D. Fluoroquinolones

Correct answer: D

Rationale: Fluoroquinolones are known to be associated with tendon dysfunction or rupture. These drugs can weaken the tendons, leading to potential issues such as tendonitis or even tendon rupture. It is essential for healthcare providers to be cautious when prescribing fluoroquinolones, especially in patients who may be at higher risk for tendon-related complications.

4. How is lithium typically administered?

• A. Intravenously
• B. Intramuscularly
• C. Orally
• D. Sublingually

Correct answer: C

Rationale: Lithium is typically administered orally to ensure proper absorption and distribution in the body. By taking lithium orally, it allows the medication to be absorbed through the gastrointestinal tract and distributed effectively. Intravenous and intramuscular routes are not commonly used for lithium administration as they can lead to rapid, unpredictable absorption and increase the risk of toxicity. Sublingual administration is also not the typical route for lithium, as it is usually taken orally for consistent and controlled absorption.

5. A client in a coronary care unit is being admitted after CPR post cardiac arrest. The client is receiving IV lidocaine at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions?

• A. Prevents dysrhythmias
• B. Slows intestinal motility
• C. Dissolves blood clots
• D. Relieves pain

Correct answer: A

Rationale: Lidocaine is administered to prevent dysrhythmias by delaying conduction in the heart and reducing the automaticity of heart tissue. This action helps stabilize the heart's electrical activity and prevent life-threatening arrhythmias post-cardiac arrest. Choices B, C, and D are incorrect as lidocaine is not used for slowing intestinal motility, dissolving blood clots, or relieving pain in this context.

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