Nursing Elites

1. A healthcare professional is preparing to administer ceftriaxone 1 g IM to a client who has a pelvic infection. Which of the following actions should the healthcare professional plan to take?

• A. Administer the medication via IM bolus over 5 minutes.
• B. Reconstitute with 0.9% sodium chloride.
• C. Discard the reconstituted medication if it is cloudy.
• D. Administer the medication in a large muscle.

Correct answer: D

Rationale: Administering ceftriaxone in a large muscle is crucial for proper absorption and to reduce the risk of pain or tissue irritation. Intramuscular administration of ceftriaxone helps achieve optimal therapeutic levels in the bloodstream for the treatment of the pelvic infection. Choices A, B, and C are incorrect. Choice A is not recommended as ceftriaxone should not be administered as a bolus over 5 minutes. Choice B is irrelevant because the question is about the administration route, not the reconstitution process. Choice C is also irrelevant as it does not pertain to the administration but to the quality of the reconstituted medication.

2. A client is prescribed clopidogrel. What laboratory result should be monitored by the nurse?

• A. White blood cell count
• B. Creatinine
• C. Blood glucose
• D. Platelet count

Correct answer: D

Rationale: When a client is prescribed clopidogrel, monitoring the platelet count is essential. Clopidogrel is an antiplatelet medication that works by preventing blood clots. Monitoring the platelet count is crucial in assessing the risk of thrombocytopenia, a potential side effect of clopidogrel. Monitoring white blood cell count, creatinine, or blood glucose is not directly related to the action or side effects of clopidogrel, making choices A, B, and C incorrect.

3. The nurse is caring for a client with coronary artery disease (CAD) who reports chest pain. The nurse administers nitroglycerin as prescribed. What is the next priority action?

• A. Obtain a 12-lead ECG
• B. Monitor the client's blood pressure
• C. Notify the healthcare provider
• D. Administer a second dose of nitroglycerin

Correct answer: B

Rationale: After administering nitroglycerin, the next priority action is to monitor the client's blood pressure. Nitroglycerin can cause vasodilation and subsequent hypotension, so it is crucial to assess the client's blood pressure to prevent complications and ensure safety. Obtaining a 12-lead ECG may be necessary but monitoring blood pressure takes precedence to detect and manage potential hypotension. Notifying the healthcare provider can be done after ensuring the client's stability. Administering a second dose of nitroglycerin without assessing the client's response and blood pressure can lead to further hypotension.

4. When preparing to administer medication to a client, what action should the nurse take first?

• A. Verify the client's identity.
• B. Check the medication expiration date.
• C. Review the client's medical history.
• D. Obtain the client's vital signs.

Correct answer: A

Rationale: Verifying the client's identity is the initial and most critical step in medication administration. It is crucial to confirm that the right medication is being given to the correct patient. Checking the client's identity helps prevent medication errors and ensures patient safety. Checking the medication expiration date (choice B) is important but should come after verifying the client's identity. Reviewing the client's medical history (choice C) is valuable but not the first step in medication administration. Obtaining the client's vital signs (choice D) is essential in some situations but is usually not the first action needed before administering medication.

5. The client is being taught about the use of sublingual nitroglycerin for chest pain. Which instruction should be provided?

• A. Swallow the tablet whole with water.
• B. Place the tablet under the tongue and let it dissolve.
• C. Chew the tablet and then swallow.
• D. Place the tablet between the cheek and gum.

Correct answer: B

Rationale: The correct method for administering sublingual nitroglycerin is to place the tablet under the tongue and allow it to dissolve. This route of administration facilitates rapid absorption of the medication into the bloodstream, enabling quick relief of chest pain associated with angina or heart conditions. Choice A is incorrect because sublingual nitroglycerin should not be swallowed whole. Choice C is wrong as chewing the tablet can lead to the rapid release of the drug, causing adverse effects like headaches or dizziness. Choice D is also incorrect as the tablet should not be placed between the cheek and gum, but under the tongue for proper absorption.

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