Nursing Elites

1. A nurse is caring for a client prescribed clopidogrel. Which of the following client histories is a contraindication to the administration of this medication?

• A. Recent surgery
• B. Peptic ulcer disease
• C. Bleeding disorder
• D. Uncontrolled hypertension

Correct answer: D

Rationale: The correct answer is D: Uncontrolled hypertension. Clopidogrel should not be administered to clients with uncontrolled hypertension due to the increased risk of bleeding. Recent surgery, peptic ulcer disease, and bleeding disorders are not absolute contraindications for clopidogrel administration.

2. A client is receiving chemotherapy and develops stomatitis. Which of the following interventions should the nurse include in the client's plan of care?

• A. Apply warm compresses to the mouth
• B. Rinse mouth with alcohol-free mouthwash
• C. Increase fluid intake
• D. Clean the mouth gently with a soft toothbrush after meals

Correct answer: A

Rationale: The correct answer is to apply warm compresses to the mouth. Stomatitis is an inflammation of the mucous lining in the mouth and can be a side effect of chemotherapy. Warm compresses can help soothe the affected area and promote healing. Choice B is incorrect because alcohol-based mouthwash can further irritate the mouth. Choice C is also a good intervention as increasing fluid intake can help keep the mouth moist and promote healing. However, the most direct intervention for soothing and healing the affected area is applying warm compresses. Choice D is incorrect because using a firm toothbrush can be too harsh and cause further irritation.

3. A 45-year-old client is taking methylprednisolone. What pharmacologic action should the nurse expect with this therapy?

• A. Suppression of beta2 receptors
• B. Suppression of airway mucus production
• C. Fortification of bones
• D. Suppression of candidiasis

Correct answer: B

Rationale: The correct answer is B: Suppression of airway mucus production. Corticosteroids like methylprednisolone are known to suppress airway mucus production. This action helps in reducing inflammation and swelling in the airways, making breathing easier for individuals with conditions like asthma or COPD. Choices A, C, and D are incorrect. Suppression of beta2 receptors is more related to beta-blockers, fortification of bones is associated with medications like bisphosphonates, and suppression of candidiasis is not a typical pharmacologic action of methylprednisolone.

4. A nurse is caring for a client with diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

• A. 14 units
• B. 28 units
• C. 32 units
• D. 42 units

Correct answer: D

Rationale: The nurse should combine both orders of insulin in the same syringe. To prepare the correct dose, the nurse should withdraw the regular insulin first (14 units) and then the NPH insulin (28 units), totaling 42 units. This combination ensures the client receives the prescribed doses of both types of insulin. Choices A, B, and C are incorrect because the nurse needs to prepare and administer both types of insulin as prescribed, resulting in a total of 42 units in the syringe.

5. A nurse is providing client education on how to administer insulin. Which of the following instructions should the nurse include?

• A. Administer the insulin into the deltoid muscle
• B. Rotate injection sites to prevent lipodystrophy
• C. Massage the site after injection
• D. Use the same site for each injection

Correct answer: B

Rationale: The correct instruction for administering insulin is to rotate injection sites to prevent lipodystrophy, a common complication of insulin therapy. Injecting into the deltoid muscle (Choice A) is not recommended for insulin injections. Massaging the site after injection (Choice C) is not necessary and can potentially increase the risk of lipodystrophy. Using the same site for each injection (Choice D) can lead to localized tissue damage and absorption irregularities, making it an incorrect choice.

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