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 has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to the same site each day.
• B. Remove the patch at night.
• C. Cover the patch with a heating pad.
• D. Apply the patch to a hairless area of skin.

Correct answer: D

Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This is important for proper absorption of the medication. Additionally, rotating the patch to different sites each day helps prevent skin irritation and ensures optimal therapeutic effect. Applying the patch to the same site each day can lead to skin irritation or tolerance development. Removing the patch at night is not necessary as the patch is typically worn continuously to provide a consistent level of medication. Covering the patch with a heating pad is contraindicated as it can increase drug absorption, potentially leading to adverse effects.

3. When providing discharge instructions to a client with a new prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it is essential to avoid salt substitutes containing potassium, which can further increase potassium levels in the body. This instruction aims to prevent potential adverse effects and ensure the client's safety while taking Lisinopril. Choices B, C, and D are incorrect because Lisinopril is typically taken once a day in the morning, it can lead to hyperkalemia (so increasing potassium-rich foods is not advised), and it can be taken with or without food.

4. Which of the following is not a side effect of Sympathoplegics (Clonidine)?

• A. Hypertension
• B. Difficulty breathing
• C. Dry oral cavity
• D. Lethargic behavior

Correct answer: A

Rationale: The correct answer is A. Clonidine, a Sympathoplegic, typically causes hypotension rather than hypertension. The other side effects associated with Clonidine include dry oral cavity, lethargic behavior, and difficulty breathing, making them incorrect choices in this context.

5. A healthcare provider is planning care for a client with brain cancer experiencing headaches. Which of the following adjuvant medications is indicated for this client?

• A. Dexamethasone
• B. Methylphenidate
• C. Hydroxyzine
• D. Amitriptyline

Correct answer: A

Rationale: Dexamethasone, a glucocorticoid, is indicated for clients with brain cancer experiencing headaches as it decreases inflammation and swelling. It is commonly used to reduce cerebral edema and relieve pressure caused by the tumor. Methylphenidate (Choice B) is a central nervous system stimulant used in conditions like ADHD and narcolepsy, not for brain cancer headaches. Hydroxyzine (Choice C) is an antihistamine used for anxiety and allergic conditions, not indicated for brain cancer headaches. Amitriptyline (Choice D) is a tricyclic antidepressant used for depression, neuropathic pain, and migraine prophylaxis, but not typically indicated for brain cancer headaches.

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