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 client is being discharged and will start long-term oral prednisone for chronic asthma treatment. The client should monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is an adverse effect of oral prednisone due to sodium and water retention, which leads to fluid retention. This can be monitored by tracking weight changes. Nervousness (Choice B) is not a common adverse effect of prednisone. Bradycardia (Choice C) is not typically associated with prednisone use; in fact, tachycardia can be more common. Constipation (Choice D) is not a prominent adverse effect of prednisone.

3. A client has a new prescription for Omeprazole. Which of the following instructions should the nurse include?

• A. Take this medication before meals.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication before meals.' Omeprazole is a proton pump inhibitor that is most effective in reducing stomach acid production when taken before meals. This timing helps the medication work optimally by inhibiting acid secretion that occurs in response to food intake. Choice B ('Take this medication with food') is incorrect because Omeprazole should be taken before meals. Choice C ('Take this medication at bedtime') is incorrect as the optimal timing is before meals, not at bedtime. Choice D ('Take this medication with antacids') is incorrect because Omeprazole should not be taken with antacids as they can interfere with its absorption.

4. Which statement is true about food and drug precautions?

• A. Limiting certain types of food or administering certain types of drugs is necessary.
• B. Certain combinations of food and drugs can cause adverse reactions.
• C. Precautions may involve limiting certain types of food or administering drugs rather than restricting the drug itself.
• D. When one drug alters the way another drug affects the body.

Correct answer: B

Rationale: The correct answer is B. Certain combinations of food and drugs can indeed lead to adverse reactions. It is important to be cautious with the simultaneous intake of food and drugs as interactions between them can affect their efficacy and safety. Choices A, C, and D are incorrect because they do not accurately reflect the potential risks associated with the combination of food and drugs.

5. A client with migraine headaches is starting prophylaxis therapy with Propranolol. Which finding in the client's history should the nurse report to the provider?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with first-degree heart block due to its negative inotropic and chronotropic effects. The nurse should report this finding to the provider to consider an alternative therapy to prevent potential worsening of cardiac conduction abnormalities. Choices A, B, and C are not directly contraindications to Propranolol therapy for migraine headaches and do not pose immediate risks that would require reporting to the provider.

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