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. A healthcare provider is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare provider to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction. Choices A, C, and D are important aspects of transfusion safety but are not directly related to preventing acute hemolytic reactions. Ensuring a patent IV line, monitoring vital signs, and staying with the client are all essential during transfusion but do not specifically address the risk of ABO or Rh incompatibility reactions.

3. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypertension
• C. Bone marrow suppression
• D. Constipation

Correct answer: C

Rationale: The correct answer is bone marrow suppression (Choice C). Methotrexate can lead to bone marrow suppression, resulting in adverse effects such as anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is essential to prevent complications and adjust treatment as needed. Choices A, B, and D are incorrect. Insomnia, hypertension, and constipation are not typically associated with methotrexate use in the treatment of Rheumatoid Arthritis.

4. A client has a new prescription for Ferrous sulfate. Which of the following instructions should be included?

• A. Take this medication with milk.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication with antacids.

Correct answer: B

Rationale: The correct answer is B: 'Take this medication on an empty stomach.' Ferrous sulfate is best absorbed on an empty stomach. Instruct the client to take it 1 hour before or 2 hours after meals to maximize absorption and avoid interactions with food or beverages that may decrease absorption. Choice A is incorrect because taking Ferrous sulfate with milk can decrease its absorption. Choice C is incorrect as there is no specific benefit to taking it before bedtime. Choice D is incorrect as antacids can interfere with the absorption of Ferrous sulfate.

5. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of a transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously. Injection-site redness and swelling are common adverse effects. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for any potential issues or reactions.

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