Nursing Elites

1. A healthcare provider has just administered a wrong medication to a client. Which of the following actions should the provider take next?

• A. No action is needed
• B. Report error to the provider
• C. Complete an institutional incident report
• D. Inform the client that the wrong medication was given

Correct answer: B

Rationale: In the scenario where a wrong medication has been administered, it is crucial for the healthcare provider to report the error to the provider. This action is essential to ensure that the provider is informed promptly, corrective measures are taken, and the client's well-being is safeguarded. Choice A is incorrect as taking no action could lead to serious consequences and compromise patient safety. Choice C, while important, should come after reporting the error to the provider. Choice D is not the immediate priority as the provider should first focus on addressing the error internally.

2. A nurse is administering metformin to a client with type 2 diabetes. Which of the following adverse effects should the nurse monitor for in this client?

• A. Diarrhea
• B. Hyperglycemia
• C. Hypoglycemia
• D. Lactic acidosis

Correct answer: D

Rationale: The correct answer is D, Lactic acidosis. Lactic acidosis is a rare but serious adverse effect of metformin use. Metformin is not known to cause hyperglycemia or hypoglycemia. Diarrhea is a common gastrointestinal side effect of metformin but is not as serious as lactic acidosis, which requires immediate medical attention.

3. A nurse is caring for a client prescribed enoxaparin for deep vein thrombosis prophylaxis. Which of the following client assessments requires immediate intervention?

• A. Platelet count of 95,000/mm³
• B. Blood pressure of 145/90 mmHg
• C. Heart rate of 95 beats per minute
• D. Pain at the injection site

Correct answer: A

Rationale: A platelet count of 95,000/mm³ requires immediate intervention as it is low and increases the risk of bleeding, which is a potential complication of enoxaparin therapy. Low platelet counts can predispose the patient to hemorrhage, and administering anticoagulants like enoxaparin in such cases can further increase the bleeding risk. Monitoring platelet counts is crucial during anticoagulant therapy to prevent serious bleeding complications. The other options do not pose immediate risks related to enoxaparin therapy. A slightly elevated blood pressure, a heart rate of 95 beats per minute, and pain at the injection site are common findings that may not warrant immediate intervention in this context.

4. A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication?

• A. Take the medication on an empty stomach to maximize absorption
• B. Notify your provider if your stool becomes dark green
• C. Decrease dietary fiber intake while taking this medication
• D. Take prescribed antacids at the same time as this medication

Correct answer: A

Rationale: The correct answer is A. The nurse should instruct clients to take iron on an empty stomach, 1 hour before meals to maximize absorption. This enhances the medication's effectiveness. Option B is incorrect because dark green stool is a common side effect of iron supplements and does not necessarily indicate a problem. Option C is incorrect as dietary fiber intake does not need to be decreased while taking iron supplements. Option D is incorrect because antacids can interfere with the absorption of iron and should not be taken at the same time.

5. A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism?

• A. Scleroderma
• B. Osteoporosis
• C. Asthma
• D. Peripheral Vascular Disease

Correct answer: B

Rationale: The correct answer is B: Osteoporosis. Osteoporosis is a concern with levothyroxine as it can increase the risk for fractures, particularly in older adults. Levothyroxine treatment can exacerbate bone loss in individuals with osteoporosis. Choices A, C, and D are not directly contraindicated with levothyroxine therapy for hypothyroidism.

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