Nursing Elites

1. A healthcare professional is caring for a client who has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the healthcare professional perform first?

• A. Urine output
• B. Bowel sounds
• C. Pain level
• D. Respiratory rate

Correct answer: D

Rationale: The healthcare professional should prioritize assessing the client's respiratory rate because respiratory depression is a life-threatening adverse effect of Morphine. Monitoring the respiratory rate allows for early detection of potential complications and timely intervention to prevent harm. Assessing urine output, bowel sounds, and pain level are important but should come after ensuring the client's respiratory status is stable as it is the most critical assessment to prevent serious complications associated with opioid use.

2. A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

• A. Apply the patch to a different location each day.
• B. Remove the patch every night before bedtime.
• C. Massage the patch area gently after application.
• D. Shave the area before applying the patch.

Correct answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.

3. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

• A. It can take several weeks before you feel like the medication is helping.
• B. Take the medication just before bedtime to promote sleep.
• C. You should take the medication when needed for obsessive urges.
• D. Monitor for weight gain while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Paroxetine, an antidepressant commonly used for OCD, typically takes 1 to 4 weeks before the client experiences the full therapeutic benefit. Therefore, informing the client that it may take several weeks before feeling the medication's effects is crucial to manage expectations and ensure compliance with the treatment plan. Choice B is incorrect because Paroxetine is usually taken in the morning due to its activating effects and may cause insomnia if taken before bedtime. Choice C is incorrect because Paroxetine should be taken regularly as prescribed, not just when experiencing obsessive urges. Choice D is incorrect because although weight gain can be a side effect of Paroxetine, it is not a priority instruction compared to the delayed onset of therapeutic effects.

4. When teaching a patient to take their own pulse, which medication should the nurse instruct them to monitor? (Hint: if pulse is <60 or >100, the patient should contact their healthcare provider before taking the medication)

• A. Digoxin
• B. Lithium
• C. Montelukast
• D. Phenytoin

Correct answer: A

Rationale: It is essential for patients taking Digoxin to monitor their pulse regularly. If their pulse falls below 60 or exceeds 100 beats per minute, they should contact their healthcare provider immediately. This is crucial due to Digoxin's potential to affect heart rate, making pulse monitoring a vital aspect of patient care while on this medication.

5. A patient is prescribed acetaminophen 650 mg PO every 6 hr PRN for pain. The available acetaminophen liquid is 500 mg/5 mL. How many mL should the nurse administer per dose?

• A. 6.5 mL
• B. 7 mL
• C. 5 mL
• D. 8 mL

Correct answer: A

Rationale: To calculate the volume to administer: (Desired dose / Concentration) = Volume to administer. In this case, (650 mg / 500 mg) x 5 mL = 6.5 mL. Therefore, the nurse should administer 6.5 mL of acetaminophen liquid per dose to provide the prescribed 650 mg of acetaminophen. Choice B, 7 mL, is incorrect because the correct calculation results in 6.5 mL. Choice C, 5 mL, is incorrect as it is the concentration of the acetaminophen liquid, not the final volume needed. Choice D, 8 mL, is incorrect because it does not reflect the accurate calculation based on the prescription and concentration.

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