Nursing Elites

1. When administering IV Acyclovir to a client with Varicella, what action should the nurse take?

• A. Administer a stool softener
• B. Decrease fluid intake following infusion
• C. Infuse Acyclovir over 1 hr
• D. Monitor for hypotension

Correct answer: C

Rationale: When administering IV Acyclovir to a client with Varicella, the nurse should infuse the medication over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects such as renal damage. Therefore, it is crucial to follow the recommended infusion rate to ensure the client's safety and well-being. Choice A is incorrect as stool softeners are not indicated in this situation. Choice B is incorrect because fluid intake should be maintained or increased to prevent dehydration and support kidney function. Choice D is incorrect as monitoring for hypotension is not specifically related to the administration of IV Acyclovir in Varicella.

2. A client has a new prescription for Cyanocobalamin (Vitamin B12) injections. Which of the following client statements indicates an understanding of the teaching?

• A. I will need to take this medication for the rest of my life.
• B. I will stop taking the medication when my symptoms improve.
• C. I should take this medication with food.
• D. I will need to avoid green, leafy vegetables while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Clients with pernicious anemia or other causes of vitamin B12 deficiency may need to take cyanocobalamin for life to prevent deficiency. It is a lifelong treatment in many cases to maintain adequate B12 levels. Choice B is incorrect because stopping the medication when symptoms improve may lead to a relapse of the deficiency. Choice C is incorrect as cyanocobalamin injections are usually administered on an empty stomach. Choice D is incorrect as there is no need to avoid green, leafy vegetables while taking cyanocobalamin; in fact, these vegetables are good dietary sources of vitamin B12.

3. A client with heart failure is prescribed digoxin. Which of the following findings should the nurse identify as an adverse effect of digoxin?

• A. Constipation
• B. Blurred vision
• C. Nausea
• D. Headache

Correct answer: B

Rationale: Blurred vision is a common adverse effect of digoxin and can indicate toxicity. Monitoring for visual changes is essential to prevent serious complications in clients taking digoxin.

4. A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.

5. A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism?

• A. Performing hand hygiene before and after IV insertion
• B. Rotating IV sites at least every 72 hours
• C. Minimizing tourniquet time
• D. Avoiding reinserting the needle into an IV catheter

Correct answer: D

Rationale: To minimize the risk of catheter embolism, it is crucial to avoid reinserting the needle into an IV catheter. This practice can potentially sever the end of the catheter, leading to catheter embolism. Proper insertion techniques, securement, and avoiding unnecessary manipulations of the catheter can help prevent this serious complication.

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