Nursing Elites

1. Why is prostaglandin E1 prescribed for a child with transposition of the great arteries?

• A. Prevents hypercyanotic (blue or tet) spells
• B. Maintains an adequate hormone level
• C. Maintains the position of the great arteries
• D. Provides adequate oxygen saturation and maintains cardiac output

Correct answer: D

Rationale: Prostaglandin E1 is prescribed for a child with transposition of the great arteries to increase blood mixing, which helps maintain adequate oxygen saturation and cardiac output. This medication does not prevent hypercyanotic spells, maintain hormone levels, or influence the position of the great arteries.

2. A client has been prescribed cyclosporine (Sandimmune). Which food item should the client avoid based on the medication's interaction?

• A. Red meats
• B. Orange juice
• C. Grapefruit juice
• D. Green, leafy vegetables

Correct answer: C

Rationale: Grapefruit juice should be avoided when taking cyclosporine because it inhibits the metabolism of the medication, leading to increased blood levels and a higher risk of toxicity. It is important for the client to follow this dietary instruction to ensure the safe and effective use of cyclosporine.

3. A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?

• A. I will take my pills every day at the same time.
• B. I will be certain to avoid alcohol consumption.
• C. I have already called my family to pick up a Medic-Alert bracelet.
• D. I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.

Correct answer: D

Rationale: Ecotrin is an aspirin-containing product and should be avoided. Clients should avoid alcohol consumption, take prescribed medication at the same time each day, and use a Medic-Alert bracelet for emergency information.

4. A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:

• A. Treat thyroid storm.
• B. Prevent cardiac irritability.
• C. Treat hypocalcemic tetany.
• D. Stimulate the release of parathyroid hormone.

Correct answer: C

Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.

5. Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with prednisone?

• A. An additional dose of prednisone daily
• B. A decreased amount of daily Humulin NPH insulin
• C. An increased amount of daily Humulin NPH insulin
• D. The addition of an oral hypoglycemic medication daily

Correct answer: C

Rationale: When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.

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