Nursing Elites

1. A client with peptic ulcer disease reports a headache. Which of the following medications should the nurse plan to administer?

• A. Ibuprofen
• B. Naproxen
• C. Aspirin
• D. Acetaminophen

Correct answer: D

Rationale: Acetaminophen is the preferred analgesic for clients with peptic ulcer disease because it does not cause gastrointestinal irritation, unlike Ibuprofen, Naproxen, and Aspirin, which can exacerbate peptic ulcer symptoms and lead to gastrointestinal complications.

2. A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching?

• A. Respiratory depression can occur within 7 minutes after the morphine is administered.
• B. The morphine will peak within a few minutes.
• C. Withhold the morphine if the client has a respiratory rate less than 16/min.
• D. Administer the morphine over 2 minutes.

Correct answer: A

Rationale: The correct answer is A because respiratory depression is a significant risk when administering morphine, and it can occur within 7 minutes after administration. This information is crucial for the nurse to recognize and respond promptly. Choice B is incorrect because the peak effect of morphine via IV bolus is typically reached within a few minutes, not specifically 10 minutes. Choice C is incorrect because withholding morphine based solely on a respiratory rate less than 16/min may not be appropriate without considering other factors such as pain level, oxygen saturation, and overall respiratory status. Choice D is incorrect because administering morphine over 2 minutes may not prevent respiratory depression if it occurs rapidly after administration. Nurses should be vigilant for signs of respiratory depression regardless of the administration duration.

3. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?

• A. Increases blood pressure
• B. Prevents esophageal bleeding
• C. Decreases heart rate
• D. Reduces ammonia levels

Correct answer: D

Rationale: The correct answer is D: Reduces ammonia levels. Lactulose is used to reduce blood ammonia levels in clients with hepatic encephalopathy. Options A, B, and C are incorrect because lactulose does not have the therapeutic effect of increasing blood pressure, preventing esophageal bleeding, or decreasing heart rate.

4. A nurse is reviewing the laboratory values for a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take?

• A. Administer vitamin K
• B. Reduce the infusion rate
• C. Give the client a low-dose aspirin
• D. Request an INR

Correct answer: B

Rationale: An aPTT of 90 seconds is elevated, indicating a risk of bleeding due to excessive anticoagulation. The appropriate action is to reduce the infusion rate of heparin to prevent further complications. Administering vitamin K is not indicated for an elevated aPTT due to heparin therapy. Giving the client a low-dose aspirin can further increase the risk of bleeding when combined with heparin. Requesting an INR is not necessary for monitoring heparin therapy; aPTT is the more specific test for assessing heparin's therapeutic effect. Therefore, the correct action for the nurse to prepare to take is to reduce the infusion rate of heparin.

5. A healthcare professional is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the healthcare professional should recognize that which of the following findings is a contraindication to the administration of diltiazem?

• A. Hypotension
• B. Tachycardia
• C. Decreased level of consciousness
• D. History of diuretic use

Correct answer: A

Rationale: Diltiazem, a calcium channel blocker, can cause hypotension. Administering it to a client who already has hypotension could exacerbate this condition. Therefore, hypotension is a contraindication to the administration of diltiazem. Incorrect Choices: B) Tachycardia is not a contraindication for administering diltiazem in atrial fibrillation as it is commonly used to control the heart rate. C) Decreased level of consciousness may require evaluation but is not a direct contraindication to diltiazem administration. D) History of diuretic use is not a contraindication if the client is not currently experiencing hypotension.

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