Nursing Elites

1. A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects?

• A. Reye's syndrome
• B. Visual disturbances
• C. Diabetes mellitus
• D. Wilms' tumor

Correct answer: A

Rationale: The correct answer is A: Reye's syndrome. Aspirin use in children with viral infections has been associated with Reye's syndrome, a serious condition that causes swelling in the liver and brain. Visual disturbances (choice B) are not typically associated with aspirin use in children with viral infections. Diabetes mellitus (choice C) and Wilms' tumor (choice D) are not adverse effects of aspirin use in this context.

2. A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?

• A. Raynaud's phenomenon
• B. Migraine headaches
• C. Ulcerative colitis
• D. Anemia

Correct answer: B

Rationale: Ergotamine is used to treat migraine headaches by constricting blood vessels in the brain. Therefore, the correct answer is B. Choice A, Raynaud's phenomenon, is incorrect as ergotamine is not indicated for this condition. Choice C, Ulcerative colitis, is incorrect as ergotamine is not used to treat this gastrointestinal disorder. Choice D, Anemia, is incorrect as ergotamine is not prescribed for anemia.

3. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

• A. Take hydrochlorothiazide as needed for edema.
• B. Check your weight once weekly.
• C. Take the hydrochlorothiazide on an empty stomach.
• D. Take the hydrochlorothiazide in the morning.

Correct answer: D

Rationale: The correct answer is to take hydrochlorothiazide in the morning. This medication is usually advised to be taken in the morning to prevent nocturia, which is excessive urination at night. Option A is incorrect because hydrochlorothiazide should be taken daily as prescribed, not as needed for edema. Option B is incorrect as monitoring weight weekly may not be specifically related to hydrochlorothiazide therapy. Option C is incorrect as hydrochlorothiazide does not need to be taken on an empty stomach.

4. A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?

• A. Administer a small test dose before giving the full dose
• B. Infuse the medication over 30 seconds
• C. Monitor client closely for hypertension
• D. Administer cyanocobalamin as an antidote if toxicity occurs

Correct answer: A

Rationale: The correct action the nurse should plan to take when preparing to administer iron dextran IV is to administer a small test dose before giving the full dose. This is done to assess for any allergic reactions that the client may have to the medication. Choice B is incorrect because iron dextran should be infused slowly over a longer period, typically over 1-2 hours to reduce the risk of adverse reactions. Choice C is incorrect because iron dextran administration is more commonly associated with hypotension rather than hypertension. Choice D is incorrect because cyanocobalamin is not used as an antidote for iron dextran toxicity; instead, treatment for iron toxicity may involve supportive care, chelation therapy, or in severe cases, iron antidotes like deferoxamine.

5. A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take?

• A. Administer the medication into the client's abdomen.
• B. Inject the medication into a muscle.
• C. Massage the site after administering the medication.
• D. Use a 22-gauge needle to administer the medication.

Correct answer: A

Rationale: Heparin is best absorbed and less likely to cause hematomas when administered into subcutaneous tissue, specifically the abdomen, which is a common site for subcutaneous injections. Injecting heparin into a muscle (Choice B) is incorrect as it should be administered subcutaneously. Massaging the site after administering the medication (Choice C) is contraindicated as it can cause tissue damage or bruising. Using a 22-gauge needle (Choice D) is not recommended for subcutaneous injections of heparin; a smaller needle size such as 25-26 gauge is preferred for subcutaneous administration.

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