Nursing Elites

1. What is a desired outcome of the drug Phenytoin?

• A. Decrease symptoms of PTSD
• B. Resolution of signs of infection
• C. Decrease or cessation of seizures without excessive sedation
• D. Prevention or relief of bronchospasm

Correct answer: C

Rationale: The correct answer is C: Decrease or cessation of seizures without excessive sedation. Phenytoin is primarily used as an antiepileptic medication to manage and prevent seizures. It does not directly impact symptoms of PTSD (Choice A), resolution of signs of infection (Choice B), or prevention or relief of bronchospasm (Choice D). Therefore, the desired outcome of Phenytoin is to control seizures effectively while avoiding excessive sedation.

2. A client with chronic renal disease is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

• A. The leukocyte count
• B. The platelet count
• C. The hematocrit (Hct)
• D. The erythrocyte sedimentation rate (ESR)

Correct answer: C

Rationale: The correct answer is C: The hematocrit (Hct). Monitoring the hematocrit is essential to assess the therapeutic effect of epoetin alfa because this medication stimulates red blood cell production in clients with chronic renal disease. The leukocyte count (choice A) and platelet count (choice B) are not directly affected by epoetin alfa therapy. The erythrocyte sedimentation rate (ESR) (choice D) is a non-specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa.

3. A healthcare professional is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare professional to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: Obtaining help from another healthcare professional to confirm the correct client and blood product is crucial in preventing an acute hemolytic reaction during a blood transfusion. This reaction occurs due to ABO or Rh incompatibility. Verifying the correct client and blood product reduces the risk of administering the wrong blood type, which could lead to a life-threatening reaction. Checking for patency of the IV line (Choice A) is important but does not directly prevent an acute hemolytic reaction. Monitoring vital signs (Choice C) is essential for detecting transfusion reactions but does not prevent them. Staying with the client (Choice D) is important for early recognition of adverse reactions but does not address the root cause of preventing an acute hemolytic reaction.

4. Which of the following is considered a class IA Sodium Channel blocker?

• A. Mexiletine
• B. Amiodarone
• C. Quinidine
• D. Procainamide

Correct answer: D

Rationale: Procainamide is a class IA antiarrhythmic drug that acts as a sodium channel blocker by blocking fast sodium channels. Mexiletine is a class IB antiarrhythmic drug, not class IA. Amiodarone is a class III antiarrhythmic, and Quinidine is a class IA antiarrhythmic but not a sodium channel blocker.

5. A client starting highly active antiretroviral therapy (HAART) for HIV infection is being educated by a nurse on preventing medication resistance. What information should the nurse provide the client about resistance?

• A. Taking low dosages of antiretroviral medication minimizes resistance.
• B. Taking one antiretroviral medication at a time minimizes resistance.
• C. Taking medication at the same time daily without missing doses minimizes resistance.
• D. Changing the medication regimen when adverse effects occur minimizes resistance.

Correct answer: C

Rationale: To prevent the development of medication resistance, it is crucial for the client to take antiretroviral medication consistently at the same time daily without missing doses. This practice helps maintain effective drug levels in the body, reducing the risk of resistance development.

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