Nursing Elites

1. A client with asthma has a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?

• A. Check the pulse after using the inhaler.
• B. Take the medication with food.
• C. Rinse the mouth after using the inhaler.
• D. Reduce caffeine consumption.

Correct answer: C

Rationale: The correct answer is C: 'Rinse the mouth after using the inhaler.' Rinsing the mouth after using inhaled beclomethasone is crucial to prevent fungal overgrowth in the mouth, a common side effect of corticosteroid inhalers. Checking the pulse after using the inhaler (Choice A) is not directly related to the use of beclomethasone. Taking the medication with food (Choice B) is not a specific instruction for inhaled beclomethasone. While reducing caffeine consumption (Choice D) can be beneficial for some health conditions, it is not a specific instruction related to using inhaled beclomethasone.

2. Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?

• A. Antiplatelets
• B. Beta-adrenergic blockers
• C. ACE inhibitors
• D. Calcium channel blockers

Correct answer: B

Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.

3. A client with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.

4. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.

5. Which of the following is commonly used to treat migraine headaches?

• A. Beta-blockers
• B. Cholinesterase Inhibitors
• C. ACE inhibitors
• D. Anti-epileptic drugs (AEDs)

Correct answer: D

Rationale: Anti-epileptic drugs (AEDs) are often used in the management of migraine headaches due to their ability to help prevent or reduce the frequency and intensity of migraines. They work by stabilizing electrical activity in the brain, which can help in controlling migraine symptoms. While beta-blockers are also sometimes used in migraine prevention, anti-epileptic drugs are more commonly associated with migraine treatment. Cholinesterase Inhibitors are not typically used for migraine headaches, as they are more commonly associated with conditions like Alzheimer's disease. ACE inhibitors are a type of medication used to treat conditions like high blood pressure and heart failure, but they are not a first-line treatment for migraines.

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