Nursing Elites

1. A healthcare professional is caring for a group of clients receiving antimicrobial therapy. Which of the following clients should the professional plan to monitor for manifestations of antibiotic toxicity?

• A. An adolescent client with a sinus infection
• B. An older adult client with prostatitis
• C. A client who is postpartum with mastitis
• D. A middle-aged client with a urinary tract infection

Correct answer: B

Rationale: An older adult client with prostatitis who is receiving antibiotics should be monitored for toxicity due to age-related reductions in medication metabolism and excretion. Older adults are more susceptible to antibiotic toxicity, making them a high-risk group for adverse effects.

2. When a nurse assesses a client's IV catheter insertion site and notes a hematoma, which of the following actions should the nurse take? (Select all that apply.)

• A. Stop the infusion.
• B. Apply alcohol to the insertion site.
• C. Apply warm compresses to the insertion site.
• D. Elevate the client's arm.

Correct answer: C

Rationale: When a nurse detects a hematoma at the IV catheter insertion site, applying warm compresses is beneficial as it can promote healing by enhancing circulation and reducing swelling. Elevating the client's arm helps in reducing edema, which can relieve pressure, pain, and further bleeding in the hematoma area. Stopping the infusion may be necessary in certain situations, but it is not a standard action for all hematoma cases. Applying alcohol to the insertion site is discouraged as it can cause irritation and may not aid in resolving the hematoma.

3. A client has a new prescription for Captopril to treat hypertension. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Avoid salt substitutes.
• C. Increase your intake of potassium-rich foods.
• D. Expect a dry cough to develop.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to advise the client to avoid salt substitutes. Salt substitutes often contain potassium, and captopril can cause hyperkalemia. By avoiding salt substitutes, the client can prevent elevated potassium levels and associated complications.

4. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.

5. A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should NOT be used with caution in combination with which drug classes?

• A. NSAIDs
• B. Cardiac glycosides
• C. Beta blockers
• D. None of the above

Correct answer: C

Rationale: Calcium channel blockers and beta blockers should be used with caution together because they can both suppress heart function, potentially leading to bradycardia, heart block, or heart failure. NSAIDs and cardiac glycosides do not have significant interactions with calcium channel blockers in the same way, so they are not typically a cause for concern when combined.

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