Nursing Elites

1. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

2. While caring for a client receiving epoetin alfa to treat anemia, which finding should the nurse monitor for?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Leukocytosis (increased white blood cells) and hyperkalemia (high potassium levels) are not typically associated with epoetin alfa therapy. Fever is also not a common adverse effect of this medication.

3. A client with Subacute Bacterial Endocarditis is receiving Streptomycin IM among other antibiotics. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?

• A. Extremity paresthesias
• B. Urinary retention
• C. Severe constipation
• D. Complex partial seizures

Correct answer: A

Rationale: The correct answer is extremity paresthesias. Streptomycin, used to treat infections like Subacute Bacterial Endocarditis, can cause paresthesias in the hands and feet as an adverse effect. Monitoring for this symptom is vital to detect and manage it promptly. Choices B, C, and D are incorrect because urinary retention, severe constipation, and complex partial seizures are not commonly associated adverse effects of Streptomycin.

4. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital, with a long half-life of 4 days, remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should administer phenobarbital once a day to maintain a consistent therapeutic effect without the need for multiple daily doses. Administering the medication more than once a day would not be necessary and could increase the risk of side effects or toxicity. Therefore, the correct answer is to administer phenobarbital once a day.

5. A client has a prescription for Nitroglycerin. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin involves taking one tablet at the onset of chest pain, then another tablet every 5 minutes for up to three doses. This protocol aims to relieve angina symptoms. Choice A is incorrect because waiting 15 minutes between doses may delay symptom relief. Choice C is incorrect as Nitroglycerin is not typically taken at bedtime but rather during angina episodes. Choice D is incorrect because Nitroglycerin is usually taken sublingually, so it doesn't need to be taken on an empty stomach.

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