Nursing Elites

1. A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:

• A. Treat thyroid storm.
• B. Prevent cardiac irritability.
• C. Treat hypocalcemic tetany.
• D. Stimulate the release of parathyroid hormone.

Correct answer: C

Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.

2. Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?

• A. Protamine sulfate
• B. Potassium chloride
• C. Phytonadione (vitamin K)
• D. Aminocaproic acid (Amicar)

Correct answer: A

Rationale: Protamine sulfate is the antidote for heparin, working to reverse its effects in case of excessive bleeding. It should be readily available when administering heparin to manage any potential bleeding complications effectively. Potassium chloride is not the antidote for heparin and is typically used to correct low potassium levels. Phytonadione (vitamin K) is used to reverse the effects of warfarin, not heparin. Aminocaproic acid (Amicar) is used to treat or prevent excessive bleeding but is not the antidote for heparin.

3. A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus was previously well controlled with daily glyburide (DiaBeta). However, the fasting blood glucose level has recently been in the range of 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

• A. Prednisone
• B. Phenelzine (Nardil)
• C. Atenolol (Tenormin)
• D. Allopurinol (Zyloprim)

Correct answer: A

Rationale: Prednisone is known to reduce the effectiveness of oral hypoglycemic medications like glyburide and insulin, which can result in hyperglycemia. Therefore, the addition of prednisone to the client's regimen could have contributed to the elevated fasting blood glucose levels observed.

4. A healthcare professional is planning to administer amlodipine (Norvasc) to a client. The healthcare professional plans to check which of the following before giving the medication?

• A. Respiratory rate
• B. Blood pressure and heart rate
• C. Heart rate and respiratory rate
• D. Level of consciousness and blood pressure

Correct answer: B

Rationale: Before administering amlodipine, it is important to check the client's blood pressure and heart rate. Amlodipine is known to lower blood pressure and heart rate as part of its mechanism of action. Monitoring these vital signs helps ensure the safety of the client and allows for appropriate assessment of the medication's effects post-administration.

5. A client with chronic pain is prescribed transdermal fentanyl (Duragesic) patches. Which instruction should the nurse include in the teaching plan?

• A. Apply the patch to a different site each time.
• B. Avoid using heating pads over the patch.
• C. Change the patch every 72 hours.
• D. Remove the old patch before applying the new one.

Correct answer: B

Rationale: Clients using transdermal fentanyl (Duragesic) patches should avoid using heating pads over the patch as heat can increase the release of the medication, potentially leading to overdose. The patch should be applied to a different site each time, changed every 72 hours, and the old patch should be removed before applying a new one to prevent accidental overdose or excessive drug absorption.

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