Nursing Elites

1. Which of the following is NOT an opioid or NSAID?

• A. Morphine
• B. Ibuprofen
• C. Hydromorphone
• D. Acetaminophen

Correct answer: D

Rationale: Acetaminophen is the correct answer as it is not classified as an opioid or NSAID. Acetaminophen is considered a non-opioid analgesic, which means it works by a different mechanism than opioids and NSAIDs to relieve pain and reduce fever. Morphine, hydromorphone, and ibuprofen, on the other hand, are classified as opioids or NSAIDs. Morphine and hydromorphone are opioids, while ibuprofen is an NSAID (Nonsteroidal Anti-Inflammatory Drug), all of which work through different mechanisms compared to acetaminophen.

2. Which medication is a beta blocker?

• A. Atenolol (Tenormin)
• B. Verapamil (Calan)
• C. Captopril (Capoten)
• D. Clopidogrel (Plavix)

Correct answer: A

Rationale: Atenolol (Tenormin) is a beta blocker commonly used to treat conditions like hypertension and angina by blocking the action of adrenaline on the heart. Verapamil is a calcium channel blocker, Captopril is an ACE inhibitor, and Clopidogrel is an antiplatelet medication. Therefore, the correct answer is Atenolol (Tenormin) as it belongs to the beta blocker class of medications.

3. A client with chronic kidney disease has a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

• A. Iron
• B. Protein
• C. Potassium
• D. Sodium

Correct answer: A

Rationale: Patients with chronic kidney disease are often prescribed epoetin alfa to treat anemia. Epoetin alfa stimulates red blood cell production, increasing the body's demand for iron to support this process. Therefore, clients taking epoetin alfa should be advised to increase their dietary intake of iron-rich foods to meet the increased demand and prevent iron deficiency anemia. Choices B, C, and D are incorrect because while protein is essential for overall health, potassium and sodium intake may need to be restricted in clients with chronic kidney disease to manage electrolyte balance and blood pressure.

4. A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?

• A. Sodium 140 mEq/L
• B. Potassium 4.5 mEq/L
• C. BUN 55 mg/dL
• D. Glucose 120 mg/dL

Correct answer: C

Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.

5. A client is prescribed an IM dose of penicillin. The client reports developing a rash after taking penicillin 3 years ago. What should the nurse do?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The nurse should withhold the medication and inform the provider of the client's previous rash after taking penicillin. This history suggests a potential allergic reaction to penicillin, which can range from mild to severe anaphylaxis. Notifying the provider allows for an alternative antibiotic to be prescribed, considering the client's allergy to penicillin. It is crucial to avoid administering a medication that could potentially lead to a severe allergic reaction in the client. Administering the prescribed dose (Choice A) could be harmful due to the potential for an allergic reaction. Changing the prescription to an oral form (Choice C) does not address the underlying issue of a potential penicillin allergy. Administering an oral antihistamine (Choice D) without consulting the provider may not be sufficient to prevent a severe allergic reaction.

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