Nursing Elites

1. A client at 28 weeks of gestation is experiencing preterm labor. Which of the following medications should the nurse plan to administer?

• A. Oxytocin
• B. Nifedipine
• C. Dinoprostone
• D. Misoprostol

Correct answer: B

Rationale: Nifedipine is the correct choice because it is a calcium channel blocker that helps relax the uterus and stop preterm labor. Oxytocin (Choice A) is used to induce labor, not to stop preterm labor. Dinoprostone (Choice C) and Misoprostol (Choice D) are prostaglandins used to induce labor and ripen the cervix, not to stop preterm labor.

2. A client is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?

• A. Hypoglycemia
• B. Proteinuria
• C. Nasal congestion
• D. Visual disturbances

Correct answer: B

Rationale: The correct answer is B: Proteinuria. Proteinuria can indicate nephrotoxicity, a known adverse effect of gentamicin. Gentamicin is known to cause kidney damage, leading to proteinuria. Hypoglycemia is not typically associated with gentamicin use but may be related to insulin administration or other medical conditions. Nasal congestion is not a common adverse effect of gentamicin. Visual disturbances are also not typically reported with gentamicin use.

3. A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects?

• A. Reye's syndrome
• B. Visual disturbances
• C. Diabetes mellitus
• D. Wilms' tumor

Correct answer: A

Rationale: The correct answer is A: Reye's syndrome. Aspirin use in children with viral infections has been associated with Reye's syndrome, a serious condition that causes swelling in the liver and brain. Visual disturbances (choice B) are not typically associated with aspirin use in children with viral infections. Diabetes mellitus (choice C) and Wilms' tumor (choice D) are not adverse effects of aspirin use in this context.

4. A client with congestive heart failure taking digoxin reports nausea and refuses to eat breakfast. Which action should the nurse take first?

• A. Encourage the client to eat the toast on the breakfast tray.
• B. Administer an antiemetic.
• C. Inform the client's provider.
• D. Check the client's apical pulse.

Correct answer: D

Rationale: The correct action for the nurse to take first is to check the client's apical pulse. Nausea can be a sign of digoxin toxicity, and one of the early signs of digoxin toxicity is changes in the pulse rate. By checking the client's apical pulse, the nurse can assess if the digoxin level is too high. Encouraging the client to eat or administering an antiemetic may not address the underlying issue of digoxin toxicity. While informing the provider is important, assessing the client's condition through checking the apical pulse should be the immediate priority.

5. A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority?

• A. Administer the medication to the client before breakfast in the morning.
• B. Assist the client to a chair before administering the medication.
• C. Give the medication to the client with water rather than milk.
• D. Educate the client on how to take the medication at home.

Correct answer: A

Rationale: The correct answer is to administer the medication to the client before breakfast in the morning. Alendronate should be taken on an empty stomach before breakfast to ensure optimal absorption. Choice B is incorrect because assisting the client to a chair is not directly related to the administration of alendronate. Choice C is incorrect as there is no specific requirement to avoid taking alendronate with milk. Choice D is also incorrect as the priority at this moment is the correct administration of the medication in the hospital setting.

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