Nursing Elites

1. A client in the operating room received a dose of Succinylcholine, leading to muscle rigidity and a sudden rise in body temperature. The nurse should anticipate a prescription for which of the following medications?

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

Correct answer: C

Rationale: Muscle rigidity and a sudden rise in temperature are indicative of malignant hyperthermia, a potential complication of succinylcholine. Dantrolene is the drug of choice to treat malignant hyperthermia as it acts on skeletal muscles to reduce metabolic activity and counteract the symptoms. Neostigmine (Choice A) is used to reverse the effects of non-depolarizing neuromuscular blocking agents, not for malignant hyperthermia. Naloxone (Choice B) is an opioid antagonist used for opioid overdose. Vecuronium (Choice D) is a non-depolarizing neuromuscular blocking agent and is not the appropriate medication for malignant hyperthermia.

2. A client is receiving daily doses of Oprelvekin. Which of the following laboratory values should be monitored to determine the effectiveness of this medication?

• A. Hemoglobin
• B. Absolute neutrophil count
• C. Platelet count
• D. Total white blood cell count

Correct answer: C

Rationale: Oprelvekin is a medication that stimulates platelet production. Therefore, monitoring the platelet count is essential to assess the effectiveness of this drug. The expected outcome for oprelvekin therapy is a platelet count greater than 50,000/mm^3. Changes in platelet count can indicate the response to the medication and help in adjusting the treatment plan accordingly. Monitoring hemoglobin, absolute neutrophil count, or total white blood cell count is not directly related to the mechanism of action of Oprelvekin and therefore would not provide accurate information on the drug's effectiveness.

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

• A. Take this medication with meals.
• B. Avoid taking this medication with dairy products.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking this medication with dairy products.' Ciprofloxacin should not be taken with dairy products because calcium can interfere with the absorption of the medication. Instructing the client to take it 1 hour before or 2 hours after consuming dairy products will ensure optimal effectiveness of the medication. Choice A is incorrect because Ciprofloxacin is usually recommended to be taken on an empty stomach or with a full glass of water. Choice C is incorrect as there is no specific requirement to take Ciprofloxacin at bedtime. Choice D is also incorrect as there is no need to increase intake of potassium-rich foods in relation to taking Ciprofloxacin.

4. A healthcare provider is preparing to administer an Opioid agonist to a client who has acute pain. Which of the following complications should the provider monitor?

• A. Urinary retention
• B. Tachypnea
• C. Hypertension
• D. Irritating cough

Correct answer: A

Rationale: The correct answer is urinary retention. Opioid agonists like morphine can suppress the awareness of bladder fullness, leading to urinary retention. This complication can result in significant discomfort and potential urinary tract issues if not promptly addressed. Tachypnea (increased respiratory rate) is a common side effect of opioids but is not a specific complication related to urinary retention. Hypertension is not typically associated with opioid agonists and is more commonly seen with opioid antagonists. An irritating cough is not a known complication of opioid agonists and is not directly related to the effect opioids have on the urinary system.

5. A client with heart failure is prescribed digoxin. Which statement by the client indicates an adverse effect of the medication?

• A. I can walk a mile a day.
• B. I've had a backache for several days.
• C. I am urinating more frequently.
• D. I feel nauseated and have no appetite.

Correct answer: D

Rationale: Nausea and loss of appetite are common early signs of digoxin toxicity, indicating an adverse effect of the medication. These symptoms should be reported to the healthcare provider immediately for further evaluation and management.

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