Nursing Elites

1. A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?

• A. Use an electric shaver to remove excess hair on the extremity.
• B. Select the antecubital area to insert the IV catheter.
• C. Distend the veins by using a blood pressure cuff.
• D. Instruct the client to keep the extremity still during the procedure.

Correct answer: C

Rationale: Distending the veins using a blood pressure cuff is essential for facilitating visualization and access to the veins during IV catheter insertion. This technique helps healthcare professionals identify suitable veins, reducing the risk of complications like infiltration or hematoma formation. Using an electric shaver to remove hair on the extremity (Choice A) may increase the risk of micro-cuts and introduce infection. Selecting the antecubital area (Choice B) may not always be appropriate, as vein condition and accessibility vary among older adult clients. Instructing the client to keep the extremity still (Choice D) is important but is not directly related to preparing for IV therapy.

2. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: An adverse effect of prochlorperazine is acute dystonia, which is evidenced by spasms of the muscles in the face, neck, and tongue. Diphenhydramine is used to suppress extrapyramidal effects of prochlorperazine, making it the most appropriate choice to address the client's spasms. Fomepizole is used in methanol or ethylene glycol poisoning, not for acute dystonia. Naloxone is an opioid antagonist used for opioid overdose, not for acute dystonia. Phytonadione is vitamin K, used for the reversal of warfarin, not for acute dystonia.

3. A client is being educated by a healthcare provider about Terbutaline. Which of the following statements by the client indicates understanding of the teaching?

• A. This medication will stop my contractions.
• B. This medication will prevent vaginal bleeding.
• C. This medication will promote blood flow to my baby.
• D. This medication will increase my prostaglandin production.

Correct answer: A

Rationale: The correct answer is A. Terbutaline works by blocking beta2-adrenergic receptors, leading to uterine smooth muscle relaxation and stopping contractions. It is commonly used to delay preterm labor. Choice B is incorrect because Terbutaline is not used to prevent vaginal bleeding. Choice C is incorrect because Terbutaline's primary action is not related to promoting blood flow to the baby. Choice D is incorrect because Terbutaline does not increase prostaglandin production; instead, it works by blocking beta2-adrenergic receptors.

4. A client has a new prescription for rituximab. Which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The nurse should instruct the client to report fever. Fever can be an indication of an infection, a potential complication of rituximab therapy. Monitoring and reporting fever promptly can help in early intervention to prevent further complications. Dizziness, urinary frequency, and dry mouth are not typically associated with rituximab therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings to report in this scenario.

5. A client has a new prescription for Clopidogrel. Which of the following instructions should the nurse include?

• A. Monitor for signs of bleeding.
• B. Avoid taking the medication with food.
• C. Expect to have increased urination.
• D. Take the medication with an antacid.

Correct answer: A

Rationale: Corrected Rationale: Clopidogrel is an antiplatelet medication that increases the risk of bleeding. The client should monitor for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, and report them promptly to their healthcare provider for further evaluation and management. Choice B is incorrect because Clopidogrel can be taken with or without food. Choice C is incorrect as increased urination is not a common side effect of Clopidogrel. Choice D is incorrect as taking Clopidogrel with an antacid may reduce its effectiveness.

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