Nursing Elites

1. Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder?

• A. Myxedema
• B. Renal failure
• C. Hypothyroidism
• D. Diabetes mellitus

Correct answer: B

Rationale: Colchicine is contraindicated in clients with severe gastrointestinal, renal, hepatic, or cardiac disorders, or blood dyscrasias. Renal failure is a condition where the kidneys fail to function adequately, leading to the accumulation of toxins in the body. Since colchicine is contraindicated in clients with renal disorders, including renal failure, it could exacerbate the condition and worsen the client's health. Myxedema, hypothyroidism, and diabetes mellitus are not contraindications for colchicine use. While these conditions may require caution or monitoring when administering colchicine, they are not absolute contraindications like renal failure.

2. A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?

• A. My urine may turn brown or green.
• B. This medication is prescribed to help relieve my muscle spasms.
• C. If my vision becomes blurred, I need to be concerned about it.
• D. I need to call my doctor if I experience nasal congestion from this medication.

Correct answer: C

Rationale: The correct answer is C because blurred vision is an adverse effect of methocarbamol (Robaxin) and should be reported to a healthcare provider. Choices A, B, and D are all correct statements. Option A informs the client about a possible discoloration of urine, which is a known side effect. Option B correctly explains the purpose of the medication. Option D correctly advises the client to contact their doctor if they experience nasal congestion, which could indicate an adverse reaction.

3. A client is prescribed alendronate (Fosamax) for the treatment of osteoporosis. Which instruction should the nurse provide to the client?

• A. Take the medication at bedtime.
• B. Take the medication with a full glass of water.
• C. Lie down for 30 minutes after taking the medication.
• D. Take the medication with food to avoid gastrointestinal upset.

Correct answer: B

Rationale: The correct instruction for a client prescribed alendronate (Fosamax) for osteoporosis is to take the medication with a full glass of water first thing in the morning. It should be taken at least 30 minutes before any food, beverage, or other medication. The client should also remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation. Taking alendronate at bedtime or with food is not recommended as it may reduce its absorption and effectiveness.

4. A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which of the following vital signs is most important for the nurse to check before administering the medication?

• A. Temperature
• B. Respirations
• C. Blood pressure
• D. Radial pulse rate

Correct answer: C

Rationale: The correct answer is checking the client's blood pressure (C) before administering another nitroglycerin tablet. Nitroglycerin can cause hypotension, and monitoring blood pressure is crucial to prevent a sudden drop in blood pressure, especially when giving another dose of nitroglycerin.

5. A clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to a child. How is this vaccine best administered?

• A. Intramuscularly in the deltoid muscle
• B. Subcutaneously in the gluteal muscle
• C. Subcutaneously in the outer aspect of the upper arm
• D. Intramuscularly in the anterolateral aspect of the thigh

Correct answer: C

Rationale: The MMR vaccine is best administered subcutaneously in the outer aspect of the upper arm. This route allows for proper absorption and efficacy of the vaccine while minimizing the risk of injury or discomfort to the child.

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