Nursing Elites

1. What is the first type of medication prescribed to prevent angina pain for a client?

• A. Beta blockers
• B. Alpha blockers
• C. Calcium channel blockers
• D. Organic nitrates

Correct answer: A

Rationale: Beta blockers are the first-line medication prescribed to prevent angina pain. They work by reducing the heart rate and blood pressure, decreasing the heart's demand for oxygen. This helps in preventing angina attacks by improving blood flow to the heart. Alpha blockers, calcium channel blockers, and organic nitrates are also used in angina treatment but are typically considered after beta blockers.

2. A healthcare professional is preparing to administer morphine 4 mg IV to a client. Available is morphine 10 mg/mL. How many mL should the healthcare professional administer?

• A. 0.2 mL
• B. 0.4 mL
• C. 0.6 mL
• D. 0.8 mL

Correct answer: B

Rationale: To administer 4 mg from a solution of 10 mg/mL, the healthcare professional should administer 0.4 mL. The calculation is done by dividing the desired dose (4 mg) by the concentration of the solution (10 mg/mL), which equals 0.4 mL. Choice A (0.2 mL) is incorrect because it is half of the correct calculation. Choice C (0.6 mL) is incorrect because it is 50% more than the correct calculation. Choice D (0.8 mL) is incorrect because it exceeds the correct calculation.

3. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

4. A client with brain cancer and headaches is prescribed dexamethasone. What is the purpose of this adjuvant medication?

• A. To decrease inflammation and swelling
• B. To improve concentration
• C. To induce sedation
• D. To treat depression

Correct answer: A

Rationale: Dexamethasone, a glucocorticoid, is indicated for clients with brain cancer to decrease inflammation and swelling. It helps reduce cerebral edema and relieve pressure caused by the tumor, ultimately alleviating headaches. The purpose of prescribing dexamethasone in this case is not to improve concentration (choice B), induce sedation (choice C), or treat depression (choice D). Methylphenidate, a stimulant, is used for conditions like ADHD, not for brain cancer. Hydroxyzine, an antihistamine, is primarily used for anxiety and itching, not for brain cancer. Amitriptyline, a tricyclic antidepressant, is used for conditions like depression and neuropathic pain, not specifically for brain cancer-related headaches.

5. A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, what advice should the nurse provide?

• A. Avoid using acetaminophen for headaches.
• B. Restrict intake of foods high in sodium.
• C. Decrease fluid intake to less than 1,500 mL daily.
• D. Limit aerobic activity in hot weather.

Correct answer: D

Rationale: The nurse should advise the client to limit aerobic activity in hot weather to prevent sodium/water depletion, which can increase the risk for Lithium toxicity. Excessive sweating and fluid loss can lead to dehydration and changes in lithium levels, potentially resulting in toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting sodium intake and decreasing fluid intake can lead to increased lithium levels and toxicity, so these are not recommended actions.

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