Nursing Elites

1. In caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT) and presents with a pulse rate of 98/min and blood pressure of 74/44 mm Hg, the nurse should anticipate a prescription for which of the following IV medications?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Magnesium sulfate

Correct answer: A

Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A). Sodium bicarbonate (Choice B) is not indicated for hypotension related to Verapamil use. Potassium chloride (Choice C) and Magnesium sulfate (Choice D) are not the appropriate medications to address the hypotension in this situation.

2. A client has a new prescription for Sucralfate to treat a duodenal ulcer. Which of the following instructions should be included?

• A. Take the medication with meals.
• B. Swallow the tablet whole.
• C. Take the medication 1 hour before meals.
• D. Chew the tablet before swallowing.

Correct answer: C

Rationale: The correct instruction for taking Sucralfate is to take it 1 hour before meals. This timing allows the medication to coat the stomach lining, providing a protective barrier against stomach acid, which aids in healing the duodenal ulcer. Option A is incorrect as it contradicts the correct timing for taking Sucralfate. Option B is not necessary as it does not pertain to how the medication should be taken in relation to meals. Option D is incorrect as chewing the tablet before swallowing is not the correct administration method for Sucralfate.

3. 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.

4. A healthcare professional is caring for a client who is receiving treatment with carboplatin. Which of the following findings should the healthcare professional monitor?

• A. Hyperglycemia
• B. Ototoxicity
• C. Hypertension
• D. Bradycardia

Correct answer: B

Rationale: The healthcare professional should monitor the client for ototoxicity when receiving carboplatin. Ototoxicity is a known serious adverse effect associated with this medication, characterized by damage to the inner ear structures leading to hearing loss or balance issues. Monitoring for hearing changes and balance problems is crucial to detect ototoxicity early and prevent further complications. Hyperglycemia, hypertension, and bradycardia are not typically associated with carboplatin therapy.

5. A healthcare professional is planning to administer Morphine IV to a postoperative client. Which of the following actions should the healthcare professional take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea that occurs with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action the healthcare professional should take when administering Morphine IV to a postoperative client is to withhold the medication if the respiratory rate is less than 12/min. Respiratory depression is a common adverse effect of opioids like Morphine. Administering opioids when the respiratory rate is already compromised can further depress breathing, leading to life-threatening complications. Monitoring for seizures and confusion (Choice A) is not directly related to Morphine administration. Protecting the client's skin from severe diarrhea (Choice B) is not a common side effect of morphine. Administering Morphine via IV bolus (Choice D) should be done carefully but is not the most critical action in this scenario.

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