Nursing Elites

1. A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?

• A. Remove the prior dose before applying a new dose.
• B. Rub the ointment directly into the skin until it is no longer visible.
• C. Cover the applied ointment with a clean gauze pad.
• D. Apply the ointment to the same skin area each time.

Correct answer: A

Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.

2. During an admission assessment for a client with severe Aspirin toxicity, which finding should the nurse expect?

• A. Body temperature 35°C (95°F)
• B. Lung crackles
• C. Cool, dry skin
• D. Respiratory depression

Correct answer: D

Rationale: In severe Aspirin toxicity, respiratory depression is an anticipated finding due to the development of respiratory acidosis. Aspirin toxicity can lead to metabolic acidosis, causing the individual to hyperventilate initially to compensate. However, as the condition progresses, respiratory depression can occur, resulting in impaired gas exchange and respiratory acidosis.

3. A healthcare provider is caring for a client who has a new prescription for Clonidine. Which of the following adverse effects should the healthcare provider monitor?

• A. Drowsiness
• B. Dry mouth
• C. Weight gain
• D. Insomnia

Correct answer: B

Rationale: The correct answer is B: Dry mouth. Dry mouth is a common adverse effect of Clonidine. Clonidine can cause a reduction in salivary flow, leading to dry mouth. This symptom can be managed by increasing fluid intake or using sugar-free gum or candy to stimulate saliva production. Choices A, C, and D are incorrect. While drowsiness and insomnia are potential side effects of Clonidine, dry mouth is more commonly reported. Weight gain is not typically associated with Clonidine use.

4. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer intravenously to prevent injury.
• B. Ensure that the medication is kept refrigerated until just prior to administration.
• C. Do not shake the vial; gently invert it to mix before withdrawing the dose.
• D. Discard the vial after removing one dose of the medication.

Correct answer: D

Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing. It is crucial not to shake the vial but gently invert it to mix the medication before withdrawing the appropriate dose. Refrigeration is not required for Filgrastim; it should be stored at room temperature until just before administration. Choice A is incorrect because Filgrastim is typically administered subcutaneously, not intravenously. Choice B is incorrect as the medication should be stored at room temperature, not refrigerated, until administration. Choice C is incorrect as shaking the vial is not recommended for Filgrastim.

5. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following foods should the provider instruct the client to avoid?

• A. Broccoli
• B. Bananas
• C. Chicken
• D. Potatoes

Correct answer: A

Rationale: Clients taking Warfarin should avoid foods high in vitamin K, such as broccoli, as they can interfere with the effectiveness of the medication. Vitamin K can counteract the anticoagulant effects of Warfarin, potentially leading to blood clotting issues. Broccoli is rich in vitamin K, so its consumption should be consistent to avoid fluctuations in the medication's effectiveness. Bananas, chicken, and potatoes are not known to significantly interact with Warfarin and do not pose a risk of affecting its anticoagulant properties.

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