Nursing Elites

1. A healthcare provider is caring for four clients who have Peptic Ulcer Disease. The healthcare provider should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy due to its potential to induce labor. It is used to prevent ulcers in patients taking nonsteroidal anti-inflammatory drugs and is not indicated for osteoarthritis, kidney stones, or urinary tract infections. Therefore, the correct answer is A. Misoprostol should not be used in pregnant individuals as it can cause uterine contractions and potentially harm the fetus. Choices B, C, and D are incorrect as Misoprostol is not contraindicated for clients with osteoarthritis, kidney stones, or urinary tract infections.

2. A client is receiving IV Dopamine for the treatment of shock. Which of the following findings indicates that the medication is effective?

• A. Increased heart rate
• B. Decreased blood pressure
• C. Increased urine output
• D. Decreased respiratory rate

Correct answer: C

Rationale: Dopamine is a medication used in shock to increase cardiac output and improve renal perfusion. An increase in urine output indicates that the medication is effective as it shows improved renal perfusion and kidney function, which are essential for managing shock effectively. Choices A, B, and D are incorrect as an increased heart rate, decreased blood pressure, and decreased respiratory rate are not direct indicators of the effectiveness of IV Dopamine in treating shock.

3. When reviewing facility policies for IV therapy with the team, a nurse manager should remind the team that which technique helps minimize the risk of catheter embolism?

• A. Performing hand hygiene before and after IV insertion
• B. Rotating IV sites at least every 72 hours
• C. Minimizing tourniquet time
• D. Avoiding reinserting the needle into an IV catheter

Correct answer: D

Rationale: Avoiding reinserting the needle into an IV catheter is crucial to minimizing the risk of catheter embolism. Reinserting the needle can lead to the severing of the catheter's end, potentially causing a catheter embolism, a serious complication. The other options, while important for IV therapy safety, are not directly related to preventing catheter embolism.

4. When teaching a client with a new prescription for Warfarin, which herbal supplement should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: The correct answer is St. John's wort. St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism, potentially leading to decreased anticoagulant effects. Therefore, the nurse should instruct the client to avoid using St. John's wort while taking Warfarin to prevent adverse drug interactions. Echinacea, garlic, and ginseng are not the correct answers in this case. While these herbal supplements may also interact with Warfarin and affect its efficacy, St. John's wort has a well-known interaction with Warfarin that can significantly impact its anticoagulant effects. Educating the client about the specific interaction between St. John's wort and Warfarin is crucial to ensure patient safety and the medication's therapeutic benefit.

5. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?

• A. Instruct the client to self-ambulate every 2 hours.
• B. Offer oral hygiene every 2 hours.
• C. Anticipate medication administration 2 hours prior to delivery.
• D. Monitor fetal heart rate every 2 hours.

Correct answer: B

Rationale: Offering oral hygiene every 2 hours is essential for a client receiving opioid analgesics to prevent dry mouth, nausea, and vomiting, which are common adverse effects associated with opioid use. This intervention promotes comfort and enhances the client's well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate for a client in labor receiving opioid analgesics, as it may be challenging and unnecessary during this time. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's pain level and the duration of action of the opioid. Monitoring fetal heart rate every 2 hours is important during labor, but the priority in this case is to address the client's comfort and well-being by offering oral hygiene.

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