Nursing Elites

1. A client is admitted for a surgical procedure. Which preexisting condition can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine can produce psychological effects like hallucinations. Patients with schizophrenia may be more prone to experiencing exacerbation of their symptoms when exposed to Ketamine due to its potential to worsen psychotic symptoms. Therefore, schizophrenia can be a contraindication for the use of Ketamine as an anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for the use of Ketamine.

2. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in clients with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is characterized by inflammation of a vein with the formation of a clot, and estrogen can further exacerbate this condition, leading to serious complications. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and osteoporosis are conditions where estrogen therapy may actually be indicated. Dysfunctional uterine bleeding is another condition where estrogen therapy can be used to help regulate menstrual bleeding.

3. Which of the following types of insulin is classified as 'long-acting'?

• A. Lispro (Humalog)
• B. NPH (Humulin N)
• C. Regular insulin (Humulin R)
• D. Glargine (Lantus)

Correct answer: D

Rationale: The correct answer is Glargine (Lantus). Glargine is classified as a long-acting insulin due to its slow, steady release over an extended period, making it suitable for basal insulin requirements. It has a duration of action that can last up to 24 hours, helping to maintain stable blood sugar levels throughout the day. Lispro (Humalog) is a rapid-acting insulin, NPH (Humulin N) is an intermediate-acting insulin, and Regular insulin (Humulin R) is a short-acting insulin, so they are not classified as long-acting insulins.

4. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and is experiencing muscle weakness. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers by increasing acetylcholine levels at the neuromuscular junction, thereby helping to restore muscle strength. Naloxone is an opioid antagonist used to reverse opioid effects, not neuromuscular blockade. Dantrolene is a skeletal muscle relaxant used to treat malignant hyperthermia or neuroleptic malignant syndrome, not to reverse neuromuscular blockade. Vecuronium is a nondepolarizing neuromuscular blocking agent, like the one the client received, and is not used to reverse its effects.

5. A client has a prescription for ceftriaxone. Which of the following information should the nurse include in the teaching?

• A. You may develop a cough while taking this medication.
• B. You should stop taking this medication if you develop a rash.
• C. This medication cannot be given orally.
• D. This medication may cause your urine to turn yellow.

Correct answer: B

Rationale: The correct answer is B. A rash can indicate an allergic reaction to ceftriaxone, which should be reported to the provider. It is crucial to instruct the client to discontinue the medication and seek medical attention if a rash develops to prevent potential serious adverse effects. Choices A, C, and D are incorrect because cough is not a common side effect of ceftriaxone, ceftriaxone is typically administered parenterally, and a yellow discoloration of urine is a harmless side effect due to the color of the medication itself, respectively.

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