Nursing Elites

1. A 45-year-old client is taking methylprednisolone. What pharmacologic action should the nurse expect with this therapy?

• A. Suppression of beta2 receptors
• B. Suppression of airway mucus production
• C. Fortification of bones
• D. Suppression of candidiasis

Correct answer: B

Rationale: The correct answer is B: Suppression of airway mucus production. Corticosteroids like methylprednisolone are known to suppress airway mucus production. This action helps in reducing inflammation and swelling in the airways, making breathing easier for individuals with conditions like asthma or COPD. Choices A, C, and D are incorrect. Suppression of beta2 receptors is more related to beta-blockers, fortification of bones is associated with medications like bisphosphonates, and suppression of candidiasis is not a typical pharmacologic action of methylprednisolone.

2. A client is prescribed digoxin 0.125 mg daily for heart failure. Which of the following client reports should concern the nurse as a sign of digoxin toxicity?

• A. Increased appetite
• B. Visual disturbances
• C. Weight gain
• D. Constipation

Correct answer: B

Rationale: Visual disturbances such as blurred vision or seeing halos around lights are common signs of digoxin toxicity. Increased appetite, weight gain, and constipation are not typically associated with digoxin toxicity. Weight gain could be a sign of worsening heart failure rather than digoxin toxicity. Increased appetite and constipation are not specific signs of digoxin toxicity and are less likely to be related.

3. Before administering blood products, which action should be taken?

• A. Assess the client's temperature
• B. Document client response
• C. Prime IV tubing with 0.45% sodium chloride
• D. Administer epinephrine

Correct answer: A

Rationale: Correct answer: Before administering blood products, the client's temperature must be assessed to establish a baseline and monitor for transfusion reactions. Choice B is incorrect because documenting client response should occur after administering the blood products. Choice C is incorrect as priming IV tubing with 0.45% sodium chloride is not directly related to assessing the client before administering blood products. Choice D is incorrect because administering epinephrine is not a routine action before administering blood products.

4. A client is receiving magnesium sulfate for the management of preeclampsia. Which of the following client assessments should the nurse monitor to prevent complications of therapy?

• A. Bowel sounds
• B. Deep tendon reflexes
• C. Oxygen saturation
• D. Fluid balance

Correct answer: B

Rationale: The correct answer is deep tendon reflexes. Monitoring deep tendon reflexes is crucial to assess for magnesium toxicity during therapy for preeclampsia. Magnesium sulfate can lead to neuromuscular blockade, reflected by decreased or absent deep tendon reflexes. Assessing bowel sounds (choice A) is important for gastrointestinal function but is not directly related to magnesium sulfate therapy. Oxygen saturation (choice C) is vital for respiratory status but is not specifically linked to magnesium sulfate administration. Fluid balance (choice D) is essential but does not directly correlate with monitoring for complications of magnesium sulfate therapy in the context of preeclampsia.

5. A client prescribed hydromorphone for severe pain has a decreased respiratory rate from 16 breaths per minute to 6. Which of the following medications should the nurse prepare to administer?

• A. Flumazenil
• B. Naloxone
• C. Activated charcoal
• D. Aluminum hydroxide

Correct answer: B

Rationale: Naloxone is the correct answer as it is used to reverse opioid-induced respiratory depression. Hydromorphone is an opioid medication that can cause respiratory depression at high doses. Naloxone is an opioid antagonist that competes with opioids at receptor sites, reversing the effects of opioids like hydromorphone. Flumazenil (Choice A) is a benzodiazepine antagonist used for benzodiazepine overdose, not opioid overdose. Activated charcoal (Choice C) is used for toxin ingestion to prevent absorption in the gastrointestinal tract, but it is not indicated for opioid overdose. Aluminum hydroxide (Choice D) is an antacid and would not be the appropriate intervention for respiratory depression caused by opioid overdose.

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