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. Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?

• A. Platelet count
• B. Triglyceride level
• C. Complete blood count
• D. White blood cell count

Correct answer: B

Rationale: Before administering Isotretinoin, it is important to check the client's triglyceride levels. Isotretinoin is known to elevate triglyceride levels, hence monitoring them before and periodically during treatment is essential to prevent potential adverse effects.

3. A client is receiving morphine sulfate for pain management. Which assessment finding requires immediate action?

• A. Constipation
• B. Drowsiness
• C. Respiratory rate of 10 breaths per minute
• D. Nausea

Correct answer: C

Rationale: A respiratory rate of 10 breaths per minute indicates respiratory depression, a serious side effect of morphine sulfate that can lead to respiratory compromise and requires immediate intervention. Constipation, drowsiness, and nausea are common side effects of morphine but are not immediately life-threatening compared to respiratory depression. Monitoring and addressing a low respiratory rate are crucial in preventing further respiratory distress or failure.

4. When is the best time for a client to take a daily dose of prednisone?

• A. At noon
• B. At bedtime
• C. Early morning
• D. Anytime, at the same time each day

Correct answer: C

Rationale: The correct time for a client to take a daily dose of prednisone is early morning. Corticosteroids like prednisone should be taken in the morning to mimic the body's natural hormone release pattern. This timing helps reduce the risk of disrupting the body's internal clock and minimizes the potential for insomnia or other sleep disturbances.

5. A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which medication should be prepared to administer as prescribed to the client?

• A. Calcium chloride
• B. Calcium gluconate
• C. Calcitonin (Miacalcin)
• D. Large doses of vitamin D

Correct answer: C

Rationale: The normal serum calcium level ranges from 8.6 to 10.0 mg/dL. In hypercalcemia, as seen in this client, Calcitonin (Miacalcin) is used to decrease plasma calcium levels by inhibiting bone resorption. Calcium gluconate and calcium chloride are typically used for hypocalcemia, not hypercalcemia. Large doses of vitamin D should be avoided in hypercalcemia as they can exacerbate hypercalcemia by increasing calcium absorption from the intestines.

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