Nursing Elites

1. Prior to administering an oral dose of methylprednisolone, what is most important for the nurse to do?

• A. Administer the medication with a glass of milk
• B. Notify the healthcare provider of the finding
• C. Begin tapering the drug dose per protocol
• D. Teach the clients about foods high in calcium

Correct answer: A

Rationale: Administering methylprednisolone with food or milk is important as it can help reduce gastrointestinal side effects associated with the medication. This practice is commonly recommended to minimize stomach upset and irritation that may occur when taking methylprednisolone on an empty stomach. Therefore, it is crucial for the nurse to provide the medication with a glass of milk to enhance patient comfort and adherence to the treatment regimen. Choice B is incorrect as there is no indication in the question stem that suggests a need to notify the healthcare provider before administering the medication with food or milk. Choice C is incorrect because tapering the drug dose per protocol is not the immediate action needed prior to administering the first dose of methylprednisolone. Choice D is irrelevant to the administration of methylprednisolone and not the most important action to take before giving the medication.

2. What side effect is a male client likely to experience while receiving furosemide 40mg by mouth?

• A. Difficulty starting urination
• B. Nosebleeds
• C. Muscle cramps
• D. Visual disturbances

Correct answer: C

Rationale: Muscle cramps are a common side effect of furosemide due to its impact on electrolyte levels, especially potassium. Furosemide is a loop diuretic that can lead to potassium depletion, resulting in muscle cramps as one of the manifestations of electrolyte imbalances. Therefore, choices A, B, and D are incorrect. Difficulty starting urination is not a common side effect of furosemide; nosebleeds and visual disturbances are not typically associated with this medication.

3. A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?

• A. Initiate a second intravenous access site
• B. Prepare to initiate cardiopulmonary resuscitation
• C. Determine the results of the drug toxicity screen
• D. Administer an additional dose of naloxone

Correct answer: D

Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.

4. A client with chronic kidney disease is prescribed erythropoietin. The nurse should monitor for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Erythropoietin is a medication commonly used to stimulate red blood cell production in individuals with chronic kidney disease. One of the potential adverse effects of erythropoietin therapy is hypertension. The increased production of red blood cells can lead to elevated blood pressure levels. Therefore, monitoring for hypertension is essential to ensure the client's safety and well-being while on this medication. Choices B, C, and D are incorrect because hypotension, tachycardia, and bradycardia are not typically associated with erythropoietin therapy. Hypertension is the primary adverse effect to monitor in this case.

5. A client with rheumatoid arthritis is prescribed methotrexate. The nurse should include which instruction in the client's teaching plan?

• A. Avoid alcohol while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Avoid sunlight while taking this medication.
• D. Report any signs of infection to the healthcare provider.

Correct answer: C

Rationale: The correct instruction for a client prescribed methotrexate is to avoid sunlight while taking this medication. Methotrexate can increase sensitivity to sunlight, leading to skin reactions. It is essential for clients to limit sun exposure and use protective measures like sunscreen and clothing coverage to prevent adverse effects. Choices A, B, and D are incorrect because avoiding alcohol, taking with food, and reporting signs of infection are not specific instructions related to methotrexate therapy.

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