Nursing Elites

1. A healthcare provider is preparing to administer an Opioid agonist to a client who has acute pain. Which of the following complications should the healthcare provider monitor?

• A. Urinary retention
• B. Tachypnea
• C. Hypertension
• D. Irritating cough

Correct answer: A

Rationale: The correct answer is urinary retention. Opioid agonists like morphine can suppress the sensation of a full bladder, leading to urinary retention. Monitoring for this complication is crucial to prevent bladder distention and related issues. Choices B, C, and D are incorrect. Tachypnea (increased respiratory rate), hypertension (high blood pressure), and irritating cough are not typically associated with opioid agonist administration for pain management.

2. A client is prescribed an IM dose of penicillin. She reports developing a rash after taking penicillin 3 years ago. What action should the healthcare professional take?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. It is crucial to report any past allergic reactions to medications, as this information guides the provider in prescribing a safe alternative. Administering the prescribed dose without considering the client's history of developing a rash can lead to potentially severe adverse reactions. Changing the prescription to an oral form or administering an oral antihistamine does not address the risk of an allergic reaction to penicillin in this case.

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

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a side effect that affects the gums. It is crucial for the client to maintain good oral hygiene to prevent oral health complications. Choices A, B, and D are incorrect. While the timing of medication administration and dietary considerations are important, they are not directly related to preventing the specific side effect of gingival hyperplasia caused by Phenytoin.

4. What is the expected pharmacological action of propranolol?

• A. Block stimulation of beta1 receptors
• B. Alter water and electrolyte transport in the large intestine
• C. Block stimulation of beta2 receptors
• D. Both A and C are correct

Correct answer: D

Rationale: Propranolol exerts its pharmacological action by blocking stimulation of both beta1 and beta2 receptors. By doing so, it leads to decreased heart rate and blood pressure. Therefore, both options A and C are correct as propranolol affects both types of beta receptors. Choice B is incorrect as propranolol does not alter water and electrolyte transport in the large intestine.

5. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypertension
• C. Bone marrow suppression
• D. Constipation

Correct answer: C

Rationale: The correct answer is bone marrow suppression (Choice C). Methotrexate can lead to bone marrow suppression, resulting in adverse effects such as anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is essential to prevent complications and adjust treatment as needed. Choices A, B, and D are incorrect. Insomnia, hypertension, and constipation are not typically associated with methotrexate use in the treatment of Rheumatoid Arthritis.

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