Nursing Elites

1. A nurse is caring for a client receiving IV vancomycin. The nurse notes flushing of the client's neck and chest. Which of the following actions should the nurse take?

• A. Stop the infusion
• B. Document the findings as a harmless reaction
• C. Slow the infusion rate
• D. Administer diphenhydramine

Correct answer: C

Rationale: The correct action for the nurse to take when a client receiving IV vancomycin shows flushing of the neck and chest is to slow the infusion rate. Flushing is a common sign of Red Man Syndrome, which is associated with rapid infusions of vancomycin. Slowing down the infusion rate can help prevent further flushing and the development of Red Man Syndrome. Stopping the infusion (Choice A) may be too drastic if the symptoms are mild and can be managed by slowing the rate. Documenting the findings as a harmless reaction (Choice B) is incorrect because flushing should be addressed promptly to prevent complications. Administering diphenhydramine (Choice D) is not the initial or best intervention for flushing associated with vancomycin; slowing the infusion rate is the priority.

2. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

• A. Asthma
• B. Hypertension
• C. Tachydysrhythmias
• D. Urolithiasis

Correct answer: A

Rationale: The correct answer is A: Asthma. Clients with asthma should avoid Beta2 Blockade agents like propranolol as they can lead to bronchoconstriction, potentially worsening asthma symptoms. Choice B, hypertension, is not a contraindication for propranolol; in fact, it is commonly prescribed for hypertension. Choice C, tachydysrhythmias, is often an indication for propranolol due to its antiarrhythmic properties. Choice D, urolithiasis, does not directly impact the use of propranolol.

3. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take my medication as needed to alleviate symptoms
• B. I should take the medication in divided doses to ensure therapeutic drug levels
• C. I should take the medication in the morning to prevent insomnia
• D. I should take the medication on a full stomach

Correct answer: C

Rationale: Levothyroxine should be taken once in the morning to prevent insomnia and maintain therapeutic levels.

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 healthcare provider is reviewing the client's history before administering opioid pain medication. Which of the following conditions is a contraindication to opioid therapy?

• A. Asthma
• B. Renal failure
• C. Diabetes mellitus
• D. Obesity

Correct answer: B

Rationale: Renal failure is a contraindication to opioid therapy due to the risk of drug accumulation and toxicity. Asthma, diabetes mellitus, and obesity are not contraindications to opioid therapy. Asthma is a respiratory condition that can be managed alongside opioids, diabetes mellitus and obesity do not directly contraindicate opioid therapy.

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