Nursing Elites

1. A patient is receiving IV heparin for a deep-vein thrombosis and begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

• A. Vitamin K1
• B. Atropine
• C. Protamine
• D. Calcium gluconate

Correct answer: C

Rationale: Protamine is the antidote for heparin, as it reverses its anticoagulant effects. In cases of heparin overdose or if there is excessive bleeding, administering protamine can quickly neutralize the effects of heparin, helping to prevent further bleeding complications.

2. A client is taking oral Oxycodone and Ibuprofen in recommended doses. 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: When Oxycodone, a narcotic analgesic, and Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), are taken together, they work synergistically to enhance the pain-relieving effects of both medications. These drugs act through different mechanisms, leading to a combined analgesic effect that is more effective than when used alone. Therefore, the interaction between Oxycodone and Ibuprofen results in an increase in the expected therapeutic effect of both medications.

3. A healthcare professional is preparing to administer IV Vancomycin to a client who has a systemic infection. Which of the following actions should the healthcare professional take?

• A. Administer the medication rapidly over 15 minutes.
• B. Monitor the client for hypertension during infusion.
• C. Administer a test dose before the full dose.
• D. Monitor the client for Red Man Syndrome.

Correct answer: D

Rationale: The correct action for the healthcare professional is to monitor the client for Red Man Syndrome. Red Man Syndrome is a common adverse reaction to Vancomycin characterized by flushing, rash, and hypotension. It is important to monitor the client for these symptoms to intervene promptly if they occur.

4. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Take off the nitroglycerin patch if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction is to remove the nitroglycerin patch each evening to prevent tolerance. This allows for a 10- to 12-hour nitrate-free period daily, reducing the risk of developing tolerance to nitroglycerin. Cutting the patch in half is not recommended because it can alter the dosing and absorption rate, leading to inadequate symptom control. Taking off the patch for a headache is not necessary as headaches are a common side effect that may improve with continued use. Applying a new patch every 48 hours is not correct as it may not provide continuous symptom relief for angina.

5. A client is receiving imatinib. Which of the following adverse effects should the nurse monitor?

• A. Edema
• B. Constipation
• C. Dry mouth
• D. Urinary retention

Correct answer: A

Rationale: The correct answer is A: Edema. The nurse should monitor the client for edema when receiving imatinib. Imatinib, a tyrosine kinase inhibitor, can lead to fluid retention and edema as a common adverse effect. This can manifest as swelling in various parts of the body, indicating the need for close monitoring by the nurse to prevent complications related to fluid overload. Choices B, C, and D are incorrect because constipation, dry mouth, and urinary retention are not typically associated with imatinib use. Therefore, they are not the priority adverse effects to monitor in a client receiving this medication.

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