Nursing Elites

1. A client is receiving meperidine (Demerol) for pain management. Which assessment finding requires immediate action?

• A. Constipation
• B. Drowsiness
• C. Respiratory rate of 10 breaths per minute
• D. Nausea

Correct answer: C

Rationale: A respiratory rate of 10 breaths per minute indicates respiratory depression, a severe side effect of meperidine (Demerol) that necessitates immediate intervention to prevent further complications. Constipation, drowsiness, and nausea are common but less urgent side effects that do not pose an immediate life-threatening risk. Respiratory depression can lead to respiratory arrest and must be addressed promptly to ensure the client's safety and well-being.

2. A client has been prescribed furosemide (Lasix), and the nurse is monitoring for adverse effects associated with this medication. Which of the following should the nurse recognize as a potential adverse effect? Select one that doesn't apply.

• A. Nausea
• B. Tinnitus
• C. Hypotension
• D. Hypokalemia

Correct answer: A

Rationale: Furosemide is a loop diuretic that can lead to adverse effects such as tinnitus, hypotension, and hypokalemia. While nausea is a common side effect of many medications, it is not typically associated with furosemide. Therefore, the nurse should recognize nausea as a potential adverse effect that doesn't apply to furosemide.

3. 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.

4. A client is being cared for by a nurse due to severe back pain, and codeine sulfate has been prescribed. Which of the following should the nurse include in the plan of care while the client is taking this medication?

• A. Restrict fluid intake.
• B. Monitor bowel activity.
• C. Monitor for hypertension.
• D. Monitor peripheral pulses.

Correct answer: B

Rationale: When a client is prescribed codeine sulfate, it is essential to monitor bowel activity because this medication can lead to constipation. Therefore, monitoring bowel function is crucial to prevent or manage any potential gastrointestinal issues that may arise.

5. A healthcare provider has written a prescription for ranitidine (Zantac), once daily. When should the nurse schedule the medication?

• A. At bedtime
• B. After lunch
• C. With supper
• D. Before breakfast

Correct answer: A

Rationale: The correct answer is A: At bedtime. Ranitidine should be scheduled at bedtime because it provides a prolonged effect and offers the greatest protection of the gastric mucosa. Administering it at this time helps in managing nocturnal acid breakthrough and providing relief during the night.

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