Nursing Elites

1. A nurse is caring for a client who is at 14 weeks of gestation and has hyperemesis gravidarum. Which of the following medications should the nurse plan to administer?

• A. Digoxin
• B. Calcium gluconate
• C. Vitamin B6
• D. Propranolol

Correct answer: C

Rationale: The correct answer is C: Vitamin B6 (pyridoxine). Vitamin B6 is often used to treat nausea and vomiting in pregnancy, including hyperemesis gravidarum. It is considered safe for use in pregnant clients. Digoxin (Choice A) is a medication used for heart conditions, not for hyperemesis gravidarum. Calcium gluconate (Choice B) is used to treat calcium deficiencies, not nausea and vomiting in pregnancy. Propranolol (Choice D) is a beta-blocker used for conditions like hypertension and anxiety, not for hyperemesis gravidarum.

2. A nurse is planning care for a client following gastric bypass surgery. The nurse should include which of the following dietary instructions when preparing the client for discharge?

• A. Start each meal with a protein source.
• B. Consume at least 25g of fiber daily.
• C. Check your blood glucose level before each meal.
• D. Limit your meals to three times per day.

Correct answer: A

Rationale: The correct answer is A: 'Start each meal with a protein source.' Protein is crucial for healing and maintaining muscle mass after gastric bypass surgery, making it essential to include in each meal. Choice B is incorrect because immediately after surgery, the focus is typically on a low-fiber diet to aid in healing. Choice C is unrelated to the nutritional needs following gastric bypass surgery. Choice D is also incorrect as patients recovering from gastric bypass surgery may require more frequent, smaller meals to meet their nutritional needs.

3. A nurse is preparing to administer a dose of enalapril. Which of the following should the nurse assess first?

• A. Heart rate
• B. Blood pressure
• C. Serum creatinine
• D. Potassium levels

Correct answer: B

Rationale: The correct answer is to assess blood pressure first. Enalapril is an ACE inhibitor commonly used to manage hypertension. It is crucial to evaluate the patient's blood pressure before administering enalapril to ensure it is within safe limits. Assessing other parameters like heart rate, serum creatinine, and potassium levels is also important but assessing blood pressure takes precedence due to the medication's mechanism of action and potential effects on blood pressure regulation.

4. A 65-year-old client is taking methylprednisolone. What pharmacological action should the nurse expect with this therapy?

• A. Suppression of beta2 receptors.
• B. Suppression of airway mucus production.
• C. Fortification of bones.
• D. Suppression of candidiasis.

Correct answer: B

Rationale: The correct answer is B: 'Suppression of airway mucus production.' Methylprednisolone, a corticosteroid, is known to suppress airway mucus production. While corticosteroids can enhance the responsiveness of beta2 receptors, they are not directly involved in the suppression of these receptors (Choice A). Corticosteroids can lead to adverse effects such as bone loss, rather than fortification of bones (Choice C). They can also increase the risk of infections like candidiasis but do not directly suppress it (Choice D). Therefore, the most expected pharmacological action of methylprednisolone therapy is the suppression of airway mucus production.

5. A nurse is caring for a client with a new prescription for lisinopril. Which of the following should the nurse monitor?

• A. Blood pressure
• B. Liver function
• C. Serum potassium levels
• D. Heart rate

Correct answer: A

Rationale: Corrected Rationale: Lisinopril is an ACE inhibitor commonly used to lower blood pressure. Monitoring blood pressure is crucial when initiating this medication to assess its effectiveness and potential side effects related to blood pressure regulation. Liver function monitoring is not typically required with lisinopril. While lisinopril can affect potassium levels, it is not the primary parameter to monitor when starting this medication. Heart rate monitoring is not a routine requirement when initiating lisinopril therapy.

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