Nursing Elites

1. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.

2. A client has a prescription for hydrochlorothiazide to treat hypertension. The nurse should monitor the client for which of the following adverse effects?

• A. Hypokalemia
• B. Hypertension
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: Hydrochlorothiazide is a diuretic that can cause potassium loss, leading to hypokalemia. Monitoring potassium levels is crucial to prevent potential adverse effects such as cardiac arrhythmias and muscle weakness.

3. A client has a new prescription for Metoprolol to treat hypertension. Which of the following instructions should the nurse include?

• A. Stop taking the medication if your heart rate is below 70/min.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Limit your sodium intake while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client taking Metoprolol, a medication used to treat hypertension, is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down to standing up, leading to dizziness and falls. By advising the client to change positions slowly, the nurse helps prevent these adverse effects and promotes safety.

4. What is the classification for the drug valproate?

• A. Anti-diabetic
• B. Anti-convulsant
• C. Anti-ulcer agent
• D. Anti-hypertensive

Correct answer: B

Rationale: Valproate is classified as an anticonvulsant. It is commonly used to treat epilepsy and bipolar disorder by stabilizing electrical activity in the brain. Therefore, the correct classification for valproate is as an anticonvulsant. Options A, C, and D are incorrect because valproate is not used to treat diabetes, ulcers, or hypertension.

5. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: The correct answer is C, Regular insulin. Regular insulin, also known as short-acting insulin, typically exhibits a peak effect around 1 to 5 hours following administration. This rapid onset and peak effect make it suitable for managing postprandial glucose levels. Insulin glargine is a long-acting insulin with no pronounced peak effect, making it unsuitable for rapid glucose control within 1 to 5 hours. NPH insulin has an intermediate duration of action and a different peak time frame. Insulin lispro is a rapid-acting insulin that peaks within 30 minutes to 2.5 hours after administration, not within the 1 to 5-hour range.

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