Nursing Elites

1. After administering acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer, the nurse should have which item available for potential use?

• A. Ambu bag
• B. Intubation tray
• C. Nasogastric tube
• D. Suction equipment

Correct answer: D

Rationale: Acetylcysteine is administered via inhalation as a mucolytic. It helps liquefy secretions, making it easier for the client to clear them. However, in some cases, the increased volume of liquefied secretions may be challenging for the client to manage, leading to the potential need for suction equipment to assist in clearing the airway. Therefore, the nurse should have suction equipment available after administering acetylcysteine to address any issues related to excessive secretions.

2. A healthcare professional is preparing to administer an intramuscular dose of penicillin to a client with a history of anaphylactic reactions to penicillin. Which action should the healthcare professional take first?

• A. Check the medication order for accuracy.
• B. Have an epinephrine injection available.
• C. Administer a test dose to check for a reaction.
• D. Ask the client about any allergies.

Correct answer: B

Rationale: When dealing with a client who has a history of anaphylactic reactions to penicillin, the priority action for the healthcare professional is to have an epinephrine injection readily available in case of a severe allergic reaction. In such cases, the immediate focus is on being prepared to manage a potentially life-threatening situation. While checking the medication order for accuracy, administering a test dose, and asking the client about allergies are essential steps in medication administration, the first priority is ensuring the availability of epinephrine to address a severe allergic reaction promptly.

3. Which statement by the client indicates a need for further teaching about the use of metoprolol (Lopressor)?

• A. I will not stop taking the medication abruptly.
• B. I will take my pulse before taking the medication.
• C. I will take the medication with food.
• D. I will take the medication at bedtime.

Correct answer: D

Rationale: The correct answer is D because taking metoprolol (Lopressor) at bedtime is not specifically recommended. Metoprolol should be taken with food to enhance absorption. It is crucial for the client not to stop taking the medication abruptly to prevent rebound hypertension or other adverse effects. Additionally, monitoring the pulse before taking metoprolol is important for assessing its effect on heart rate.

4. When monitoring a client for acute toxicity associated with bethanechol chloride (Urecholine), what sign should the nurse check for to indicate toxicity?

• A. Dry skin
• B. Dry mouth
• C. Bradycardia
• D. Signs of dehydration

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Toxicity from bethanechol chloride (Urecholine) can lead to excessive muscarinic stimulation, resulting in manifestations like salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. When facing toxicity, treatment involves supportive measures and administering atropine sulfate subcutaneously or intravenously.

5. After the initial dose, which of the following is the priority assessment for a client being treated for acute congestive heart failure with intravenously administered bumetanide?

• A. Monitoring weight loss
• B. Monitoring temperature
• C. Monitoring blood pressure
• D. Monitoring potassium level

Correct answer: C

Rationale: The correct answer is monitoring blood pressure. Bumetanide is a loop diuretic, and monitoring blood pressure is crucial as hypotension is a common side effect. Hypotension can further worsen the condition of a patient with congestive heart failure, so assessing and managing blood pressure is a priority after administering bumetanide.

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