Nursing Elites

1. When teaching a patient to take their own pulse, which medication should the nurse instruct them to monitor? (Hint: if pulse is <60 or >100, the patient should contact their healthcare provider before taking the medication)

• A. Digoxin
• B. Lithium
• C. Montelukast
• D. Phenytoin

Correct answer: A

Rationale: It is essential for patients taking Digoxin to monitor their pulse regularly. If their pulse falls below 60 or exceeds 100 beats per minute, they should contact their healthcare provider immediately. This is crucial due to Digoxin's potential to affect heart rate, making pulse monitoring a vital aspect of patient care while on this medication.

2. A healthcare professional is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the healthcare professional expect to cause an adverse effect when administered concurrently with Fentanyl?

• A. Ampicillin
• B. Diazepam
• C. Furosemide
• D. Prednisone

Correct answer: B

Rationale: Diazepam, a CNS depressant, can interact with Fentanyl causing severe sedation when administered concurrently. This is due to the additive central nervous system depressant effects of both medications, which can lead to excessive sedation, respiratory depression, and other serious adverse effects. Therefore, healthcare professionals need to monitor clients closely for signs of excessive sedation or respiratory depression when administering these medications together.

3. While caring for a client receiving IV heparin, which of the following findings should the nurse identify as an adverse effect of this medication?

• A. Hypertension
• B. Hyperglycemia
• C. Thrombocytopenia
• D. Leukopenia

Correct answer: C

Rationale: Thrombocytopenia, a decrease in platelet count, is a known adverse effect associated with heparin therapy. It can lead to an increased risk of bleeding and should be closely monitored during treatment. Choices A, B, and D are incorrect. Hypertension is not typically associated with heparin use; hyperglycemia is not a common adverse effect of heparin; leukopenia is not a primary side effect of heparin therapy.

4. A client has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

• A. Increase intake of protein-rich foods.
• B. Expect muscle twitching to occur.
• C. Take this medication with food.
• D. Anticipate relief of manifestations in 24 hours.

Correct answer: C

Rationale: The correct instruction for the nurse to include is to advise the client to take Levodopa/Carbidopa with food. This recommendation helps reduce gastrointestinal side effects commonly associated with this medication. Food can help minimize nausea and other stomach-related issues that may occur when taking Levodopa/Carbidopa. Options A, B, and D are incorrect. Increasing intake of protein-rich foods is not necessary with this medication. Muscle twitching is not an expected side effect of Levodopa/Carbidopa. Anticipating relief of manifestations in 24 hours is unrealistic as it may take days to weeks for the full therapeutic effect of the medication to be achieved.

5. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and is experiencing muscle weakness. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers by increasing acetylcholine levels at the neuromuscular junction, thereby helping to restore muscle strength. Naloxone is an opioid antagonist used to reverse opioid effects, not neuromuscular blockade. Dantrolene is a skeletal muscle relaxant used to treat malignant hyperthermia or neuroleptic malignant syndrome, not to reverse neuromuscular blockade. Vecuronium is a nondepolarizing neuromuscular blocking agent, like the one the client received, and is not used to reverse its effects.

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