Nursing Elites

1. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: The client's symptoms of face spasms after receiving Prochlorperazine indicate acute dystonia, a known side effect. Diphenhydramine is commonly administered to manage extrapyramidal symptoms, such as muscle spasms, caused by medications like Prochlorperazine. Therefore, the nurse should anticipate a prescription for Diphenhydramine to alleviate the client's symptoms. Choices A, B, and C are incorrect because Fomepizole is used in methanol or ethylene glycol poisoning, Naloxone is an opioid antagonist used in opioid overdose, and Phytonadione is vitamin K, used to reverse the effects of certain blood thinners.

2. A healthcare professional is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the healthcare professional plan to take?

• A. Expel the air bubble from the prefilled syringe before injecting.
• B. Insert the needle completely into the client's tissue.
• C. Administer the injection in the client's thigh.
• D. Aspirate carefully after inserting the needle into the client's skin.

Correct answer: B

Rationale: Correct Answer: B. When administering enoxaparin, it is essential to insert the needle completely into the client's tissue to ensure a deep subcutaneous injection. This method helps in the appropriate delivery of the medication. Choice A is incorrect because expelling air bubbles is not necessary with subcutaneous injections and may lead to medication loss. Choice C is incorrect as enoxaparin is usually administered in the abdomen, not the thigh. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or bleeding.

3. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

4. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client be instructed to monitor for and report to the provider?

• A. Dry cough
• B. Pedal edema
• C. Bruising
• D. Yellow-tinged vision

Correct answer: D

Rationale: Yellow-tinged vision is a potential adverse effect of digoxin, which may indicate toxicity. It is crucial for the client to report this symptom promptly to the healthcare provider to prevent any further complications. Dry cough is not typically associated with digoxin use. Pedal edema is a common symptom of heart failure, which digoxin is prescribed to manage. Bruising is not a common adverse effect of digoxin.

5. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously for Rheumatoid Arthritis. Injection-site reactions such as redness and swelling are common. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for potential adverse effects.

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