Nursing Elites

1. A healthcare professional working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the healthcare professional's priority?

• A. Administer flumazenil.
• B. Identify the client's level of orientation.
• C. Infuse IV fluids.
• D. Prepare the client for gastric lavage.

Correct answer: B

Rationale: When managing a client with Benzodiazepine toxicity, the priority action for the healthcare professional is to assess the client. Identifying the client's level of orientation allows the healthcare professional to understand the client's cognitive status, which is crucial for further interventions and decision-making in the care plan. Administering flumazenil (Choice A) may precipitate withdrawal symptoms and should be done cautiously. Infusing IV fluids (Choice C) can be important but is not the priority over assessing the client. Gastric lavage (Choice D) is not typically recommended due to the risk of complications and its limited effectiveness in cases of Benzodiazepine overdose.

2. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.

3. Medications classified as angiotensin II receptor agents typically end in?

• A. Sartan
• B. Ase
• C. Olol
• D. Pril

Correct answer: A

Rationale: Angiotensin II receptor agents belong to the drug class called angiotensin II receptor blockers (ARBs). The generic names of ARBs usually end in -sartan, helping to identify this specific class of medications. Therefore, medications that end in -sartan are likely to be angiotensin II receptor agents. Choices B, C, and D are incorrect because drugs ending in -ase (like streptokinase), -olol (like propranolol), and -pril (like lisinopril) typically belong to different drug classes with distinct mechanisms of action.

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

• A. Take furosemide in the morning.
• B. Eat a diet high in potassium.
• C. Avoid foods that are high in magnesium.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct answer is to 'Eat a diet high in potassium.' Furosemide is a loop diuretic that can cause hypokalemia (low potassium levels). Instructing the client to eat a diet high in potassium can help counteract the potassium-wasting effect of furosemide and prevent hypokalemia. Choice A is incorrect because furosemide can be taken at different times of the day based on individual needs. Choice C is incorrect as furosemide does not directly interact with magnesium levels. Choice D is incorrect because while fluid intake may need to be monitored, a specific limit of 1 liter per day is not a general instruction for all clients taking furosemide.

5. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?

• A. Uroprotectant agent, such as mesna
• B. Opioid, such as morphine
• C. Loop diuretic, such as furosemide
• D. H1 receptor antagonist, such as diphenhydramine

Correct answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

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