Nursing Elites

1. Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?

• A. 45 minutes to 18 hours
• B. 30 minutes to 12 hours
• C. 90 minutes to 36 hours
• D. 60 minutes to 24 hours

Correct answer: B

Rationale: Reteplase (Retavase) is a thrombolytic medication used in the treatment of myocardial infarction (MI). It is crucial to administer this drug within 30 minutes to 12 hours following the onset of symptoms to achieve optimal therapeutic effects and improve patient outcomes. Administering Reteplase within this time frame helps in restoring blood flow to the affected areas of the heart by dissolving blood clots, reducing myocardial damage, and potentially preventing further complications associated with MI.

2. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The correct action for the healthcare professional preparing to administer IV Hydromorphone to a client is to administer the medication over 5 minutes. This slow administration is crucial to reduce the risk of hypotension and respiratory depression. Administering the medication rapidly can lead to adverse effects. Option B, administering Naloxone prior to Hydromorphone, is incorrect because Naloxone is used as an antidote for opioid overdose, not as a routine pre-medication. Option C, assessing the client's blood pressure before administration, is important but not the immediate action to take to reduce adverse effects of Hydromorphone. Option D, injecting the medication into the client's subcutaneous tissue, is incorrect as Hydromorphone is meant for intravenous administration for rapid onset of action.

3. A client with brain cancer and headaches is prescribed dexamethasone. What is the purpose of this adjuvant medication?

• A. To decrease inflammation and swelling
• B. To improve concentration
• C. To induce sedation
• D. To treat depression

Correct answer: A

Rationale: Dexamethasone, a glucocorticoid, is indicated for clients with brain cancer to decrease inflammation and swelling. It helps reduce cerebral edema and relieve pressure caused by the tumor, ultimately alleviating headaches. The purpose of prescribing dexamethasone in this case is not to improve concentration (choice B), induce sedation (choice C), or treat depression (choice D). Methylphenidate, a stimulant, is used for conditions like ADHD, not for brain cancer. Hydroxyzine, an antihistamine, is primarily used for anxiety and itching, not for brain cancer. Amitriptyline, a tricyclic antidepressant, is used for conditions like depression and neuropathic pain, not specifically for brain cancer-related headaches.

4. A client has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?

• A. Take the medication with food.
• B. Plan to take the medication at bedtime.
• C. Expect increased swelling of the ankles.
• D. Limit fluid intake in the morning.

Correct answer: A

Rationale: When educating a client about taking Hydrochlorothiazide, the nurse should advise taking the medication with food or after meals to prevent gastrointestinal upset. This medication is a diuretic, so it is important to maintain adequate fluid intake throughout the day to prevent dehydration. Taking it at bedtime is not necessary, and increased swelling of the ankles is not an expected side effect of this medication. Limiting fluid intake in the morning is not necessary and could lead to dehydration, which is a potential side effect of this diuretic.

5. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

• A. 2+ deep tendon reflexes
• B. 2+ pedal edema
• C. 24 mL/hr urinary output
• D. Respirations 12/min

Correct answer: C

Rationale: In a client receiving Magnesium Sulfate IV for Preeclampsia, a urinary output less than 25 to 30 mL/hr indicates magnesium sulfate toxicity and should be reported to the provider for further evaluation and management. Choice A, 2+ deep tendon reflexes, is a normal finding with magnesium sulfate therapy. Choice B, 2+ pedal edema, is expected in clients with preeclampsia but does not indicate magnesium sulfate toxicity. Choice D, respirations 12/min, is within the normal range and not a concerning finding related to magnesium sulfate administration.

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