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 preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number)

• A. 63 mL/hr
• B. 36 mL/hr
• C. 78 mL/hr
• D. 90 mL/hr

Correct answer: A

Rationale: To calculate the rate for the enteral tube feeding, divide the total volume by the total time: 250 mL / 4 hr = 62.5 ≈ 63 mL/hr. Therefore, the nurse should set the pump to deliver 63 mL/hr. Choices B, C, and D are incorrect as they do not match the correct calculation result. B is too low, C is too high, and D is also too high based on the correct calculation.

3. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

• A. Stop taking the isoniazid for 3 days and the discoloration should go away.
• B. Rifampin can turn body fluids orange.
• C. I'll make an appointment for you to see the provider this afternoon.
• D. Isoniazid can cause bladder irritation.

Correct answer: B

Rationale: The correct answer is B: 'Rifampin can turn body fluids orange.' Rifampin is known to cause orange discoloration of body fluids, including urine. This side effect is harmless and does not indicate a need to stop the medication. Choice A is incorrect because stopping isoniazid will not resolve the orange urine discoloration caused by rifampin. Choice C is unnecessary at this point since the orange urine is a known side effect of rifampin and does not require an urgent provider visit. Choice D is incorrect because bladder irritation is not typically associated with isoniazid.

4. A client with a seizure disorder has a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply)

• A. PTT
• B. Aspartate aminotransferase (AST)
• C. Alanine aminotransferase (ALT)
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D, 'All of the Above.' Valproic acid can impact liver function and coagulation. Monitoring the Prothrombin Time (PTT), Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) is crucial. PTT is monitored to assess coagulation status, while AST and ALT are liver enzymes that indicate liver function. Monitoring these values helps detect any potential adverse effects of valproic acid on the liver and blood clotting. Choices A, B, and C are incorrect because each of these laboratory values plays a critical role in evaluating the client's response to valproic acid therapy and detecting associated complications.

5. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypotension
• C. Bleeding
• D. Constipation

Correct answer: C

Rationale: The correct answer is C: Bleeding. Clopidogrel is an antiplatelet medication that works by preventing platelets from sticking together and forming clots. Therefore, one of the main adverse effects of clopidogrel is an increased risk of bleeding. Insomnia (Choice A), hypotension (Choice B), and constipation (Choice D) are not commonly associated with clopidogrel use. Monitoring for signs of bleeding, such as easy bruising, petechiae, or prolonged bleeding from minor cuts, is crucial when a client is taking clopidogrel.

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