Nursing Elites

1. A nurse is reviewing a client's new prescription for albuterol. What client education should the nurse provide?

• A. You may experience a dry cough after taking this medication
• B. Use this medication only as a rescue inhaler
• C. Take this medication with food to avoid nausea
• D. Use this medication daily to prevent asthma attacks

Correct answer: B

Rationale: The correct answer is B. Albuterol is a rescue inhaler that should be used during asthma attacks to provide quick relief by opening the airways. Using it daily as a preventive measure is not recommended. Choice A is incorrect because a dry cough is not a common side effect of albuterol. Choice C is incorrect as albuterol does not need to be taken with food. Choice D is incorrect because albuterol is not meant to be used daily for asthma prevention.

2. A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?

• A. Osteoporosis
• B. Hypertension
• C. Peptic ulcer disease
• D. Immunosuppression

Correct answer: C

Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.

3. A nurse is caring for a client receiving IV vancomycin. The nurse notes flushing of the client's neck and chest. Which of the following actions should the nurse take?

• A. Stop the infusion
• B. Document the findings as a harmless reaction
• C. Slow the infusion rate
• D. Administer diphenhydramine

Correct answer: C

Rationale: The correct action for the nurse to take when a client receiving IV vancomycin shows flushing of the neck and chest is to slow the infusion rate. Flushing is a common sign of Red Man Syndrome, which is associated with rapid infusions of vancomycin. Slowing down the infusion rate can help prevent further flushing and the development of Red Man Syndrome. Stopping the infusion (Choice A) may be too drastic if the symptoms are mild and can be managed by slowing the rate. Documenting the findings as a harmless reaction (Choice B) is incorrect because flushing should be addressed promptly to prevent complications. Administering diphenhydramine (Choice D) is not the initial or best intervention for flushing associated with vancomycin; slowing the infusion rate is the priority.

4. A nurse is caring for a client prescribed enoxaparin for deep vein thrombosis prophylaxis. Which of the following client assessments requires immediate intervention?

• A. Platelet count of 95,000/mm³
• B. Blood pressure of 145/90 mmHg
• C. Heart rate of 95 beats per minute
• D. Pain at the injection site

Correct answer: A

Rationale: A platelet count of 95,000/mm³ requires immediate intervention as it is low and increases the risk of bleeding, which is a potential complication of enoxaparin therapy. Low platelet counts can predispose the patient to hemorrhage, and administering anticoagulants like enoxaparin in such cases can further increase the bleeding risk. Monitoring platelet counts is crucial during anticoagulant therapy to prevent serious bleeding complications. The other options do not pose immediate risks related to enoxaparin therapy. A slightly elevated blood pressure, a heart rate of 95 beats per minute, and pain at the injection site are common findings that may not warrant immediate intervention in this context.

5. A healthcare provider has just administered a wrong medication to a client. Which of the following actions should the provider take next?

• A. No action is needed
• B. Report error to the provider
• C. Complete an institutional incident report
• D. Inform the client that the wrong medication was given

Correct answer: B

Rationale: In the scenario where a wrong medication has been administered, it is crucial for the healthcare provider to report the error to the provider. This action is essential to ensure that the provider is informed promptly, corrective measures are taken, and the client's well-being is safeguarded. Choice A is incorrect as taking no action could lead to serious consequences and compromise patient safety. Choice C, while important, should come after reporting the error to the provider. Choice D is not the immediate priority as the provider should first focus on addressing the error internally.

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