Nursing Elites

1. A client is receiving a dopamine infusion via a peripheral IV. Which of the following actions should the nurse take if the IV site appears infiltrated?

• A. Slow the infusion and continue to monitor the site
• B. Stop the infusion
• C. Apply a warm compress to the site
• D. Apply a cold compress to the site

Correct answer: B

Rationale: When an IV site appears infiltrated, it indicates that the medication is leaking into the surrounding tissues. In such a situation, the infusion should be stopped immediately to prevent further tissue damage. Choice A is incorrect because slowing the infusion would still allow the medication to leak into the tissues. Choices C and D are also incorrect as applying compresses can exacerbate the tissue damage caused by infiltration.

2. 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.

3. A client prescribed lisinopril for hypertension may experience which of the following side effects that the nurse should monitor for?

• A. Cough
• B. Weight gain
• C. Dry mouth
• D. Hyperglycemia

Correct answer: A

Rationale: A persistent dry cough is a common side effect of lisinopril. Lisinopril is an ACE inhibitor that can cause a cough due to the accumulation of bradykinin. Weight gain, dry mouth, and hyperglycemia are not typically associated with lisinopril use, making them incorrect choices in this scenario.

4. A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not associated with this therapy?

• A. Tolerance
• B. Orthostatic hypotension
• C. Headache
• D. Productive cough

Correct answer: D

Rationale: The correct answer is D: Productive cough. Nitroglycerin therapy can lead to adverse effects such as tolerance, orthostatic hypotension, and headache. However, it is not known to cause a productive cough. Tolerance may develop over time, requiring dose adjustments. Orthostatic hypotension can occur due to vasodilation effects, leading to a sudden drop in blood pressure when changing positions. Headache is a common side effect due to vasodilation of cranial blood vessels. Productive cough is not a recognized adverse effect associated with transdermal nitroglycerin therapy.

5. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?

• A. Advise the client to take the medication once daily at bedtime
• B. This medication is for the acute management of asthma
• C. Avoid dairy products while taking this medication
• D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up

Correct answer: A

Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.

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