Nursing Elites

1. A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?

• A. Initiate a second intravenous access site
• B. Prepare to initiate cardiopulmonary resuscitation
• C. Determine the results of the drug toxicity screen
• D. Administer an additional dose of naloxone

Correct answer: D

Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.

2. How does omeprazole work in treating a peptic ulcer?

• A. Increasing the production of gastric acid
• B. Neutralizing stomach acid
• C. Coating the stomach lining
• D. Reducing gastric acid secretion

Correct answer: D

Rationale: Omeprazole is a proton pump inhibitor that works by reducing gastric acid secretion. By inhibiting the enzyme responsible for pumping acid into the stomach, omeprazole helps decrease the acidity level in the stomach, providing relief from peptic ulcers. Option A is incorrect because omeprazole does not increase gastric acid production; instead, it decreases it. Option B is incorrect as omeprazole does not neutralize existing stomach acid but rather reduces its secretion. Option C is incorrect as omeprazole does not coat the stomach lining but acts on reducing acid secretion.

3. A client has sublingual nitroglycerine tablets prescribed to treat angina. The nurse realizes the client requires further education if the client makes which statements? (Select one that doesn't apply.)

• A. I will need to replace the nitroglycerine tablets every 3 to 5 months, not in a year.
• B. I should continue taking nitroglycerine tablets if I develop a headache.
• C. I understand nitroglycerine tablets do not cause addiction.
• D. If I feel dizzy when I take these, I should sit down or lie down until I feel better.

Correct answer: D

Rationale: The correct answer is D. Nitroglycerine sublingual tablets need to be replaced every 3 to 5 months, not every year, making statement A incorrect. While nitroglycerine can cause a headache, it is important to continue taking the prescribed nitroglycerine if the client has angina, making statement B accurate. Nitroglycerine tablets do not cause addiction, so statement C is correct. Dizziness and weakness are associated with the hypotensive effect of nitroglycerine; therefore, if the client feels dizzy when taking them, they should sit down or lie down until they feel better. Taking nitroglycerine tablets before an activity known to cause angina can help prevent angina attacks.

4. A client is prescribed clonidine 0.1 mg/24 hours via a transdermal patch. Which client outcome would indicate that the medication is effective?

• A. No complaints of recent episodes of angina
• B. Change in peripheral edema from +3 to +1
• C. No complaints of new onset of nausea or vomiting
• D. Blood pressure changes from 180/120 to 140/70 mm Hg

Correct answer: D

Rationale: Clonidine is an antihypertensive agent that works centrally to reduce blood pressure. A significant decrease in blood pressure, such as changing from 180/120 to 140/70 mm Hg, indicates that the medication is effectively managing hypertension. Monitoring blood pressure levels is crucial in assessing the response to clonidine therapy. Choices A, B, and C are incorrect as they do not directly relate to the therapeutic effect of clonidine in managing hypertension, which is the primary goal of the medication in this scenario.

5. A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

• A. Avoid hazardous activities until symptoms subside
• B. Contact the healthcare provider immediately
• C. Continue taking the medication every day
• D. Stop taking the medication until the unpleasant side effects wear off

Correct answer: A

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid hazardous activities until the symptoms of fatigue and dizziness subside. These side effects can impair the client's ability to engage in activities that require alertness and coordination, posing a risk for accidents. Contacting the healthcare provider immediately may not be necessary unless the symptoms worsen or persist. Continuing to take the medication every day without addressing the side effects can lead to further complications. Stopping the medication abruptly without healthcare provider guidance can also be risky and may not be necessary if the symptoms improve with time.

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