Nursing Elites

1. A healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?

• A. Warfarin
• B. Acetaminophen
• C. Ibuprofen
• D. Aspirin

Correct answer: D

Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.

2. 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.

3. A client has a new prescription for Furosemide. What instruction should be included by the nurse during discharge?

• A. Take the medication at bedtime.
• B. Increase intake of foods high in potassium.
• C. Avoid sun exposure.
• D. Limit fluid intake.

Correct answer: B

Rationale: The correct answer is to instruct the client to increase intake of foods high in potassium. Furosemide, a loop diuretic, can lead to potassium depletion. Increasing the intake of foods rich in potassium can help prevent hypokalemia, a potential side effect of Furosemide. Choice A is incorrect as Furosemide is usually recommended to be taken in the morning to avoid disrupting sleep with frequent urination. Choice C is irrelevant to the medication. Choice D is also incorrect as Furosemide is a diuretic and may require increased, not limited, fluid intake to prevent dehydration.

4. A client has a new prescription for Calcitonin-salmon for Osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication?

• A. Skin test for allergy to the medication
• B. ECG to rule out cardiac dysrhythmias
• C. Mantoux test to rule out exposure to tuberculosis
• D. Liver function tests to assess risk for medication toxicity

Correct answer: A

Rationale: Before starting Calcitonin-salmon, it is important to assess for any potential allergies as anaphylaxis can occur. A skin test is usually conducted to determine if the client is allergic to the medication. The nurse should also inquire about any previous allergies to fish, as Calcitonin-salmon is derived from salmon. Options B, C, and D are not necessary before initiating Calcitonin-salmon therapy. ECG is not directly related to this medication, Mantoux test is used to diagnose tuberculosis, and liver function tests are not specifically required before starting Calcitonin-salmon.

5. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

• A. 2+ deep tendon reflexes
• B. 2+ pedal edema
• C. 24 mL/hr urinary output
• D. Respirations 12/min

Correct answer: C

Rationale: In a client receiving Magnesium Sulfate IV for Preeclampsia, a urinary output less than 25 to 30 mL/hr indicates magnesium sulfate toxicity and should be reported to the provider for further evaluation and management. Choice A, 2+ deep tendon reflexes, is a normal finding with magnesium sulfate therapy. Choice B, 2+ pedal edema, is expected in clients with preeclampsia but does not indicate magnesium sulfate toxicity. Choice D, respirations 12/min, is within the normal range and not a concerning finding related to magnesium sulfate administration.

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