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 reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

3. The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?

• A. “I will check my weight regularly for any gain or loss.”
• B. “I’ll make sure to take my high blood pressure medications.”
• C. “I am attending a smoking cessation class.”
• D. “As long as I exercise, stress at my job will not bother me.”

Correct answer: D

Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.

4. A healthcare professional is preparing to administer IV Dantrolene to a client who has developed Malignant Hyperthermia during surgery. Which of the following actions should the healthcare professional take?

• A. Dilute the medication with sterile water and administer it rapidly.
• B. Store the medication in a refrigerator until use.
• C. Administer the medication through a large-bore IV catheter.
• D. Administer the medication via an infusion pump over 60 minutes.

Correct answer: C

Rationale: Dantrolene should be administered through a large-bore IV catheter because it is highly irritating to tissues and can cause vein irritation or thrombophlebitis if administered through a small vein. Using a large-bore IV catheter helps to minimize the risk of tissue damage and ensures proper and safe administration of the medication in emergency situations like Malignant Hyperthermia. Choices A, B, and D are incorrect because diluting the medication with sterile water and administering it rapidly can lead to tissue damage, storing the medication in a refrigerator is not necessary, and administering the medication via an infusion pump over 60 minutes is not appropriate in emergency situations like Malignant Hyperthermia where rapid administration is crucial.

5. A client has a new prescription for hydrochlorothiazide to treat hypertension. Which of the following instructions should be included?

• A. Take the medication in the morning.
• B. Increase intake of potassium-rich foods.
• C. Avoid sun exposure while taking this medication.
• D. Limit fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct instruction that should be included for a client prescribed hydrochlorothiazide is to increase the intake of potassium-rich foods. Hydrochlorothiazide, being a diuretic, can lead to hypokalemia by enhancing potassium excretion. Increasing consumption of potassium-rich foods like bananas or oranges can help prevent hypokalemia and maintain electrolyte balance. Choices A, C, and D are incorrect. Taking the medication in the morning is not a specific instruction related to hydrochlorothiazide. Avoiding sun exposure is more relevant for photosensitive medications, not hydrochlorothiazide. Limiting fluid intake to 1 liter per day is not necessary unless specifically advised by a healthcare provider.

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