Nursing Elites

1. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.

2. What is a severe adverse effect of iron supplementation?

• A. Seizures
• B. Dry mouth
• C. Edema
• D. Serotonin syndrome

Correct answer: A

Rationale: A severe adverse effect of iron supplementation is seizures. Iron toxicity can lead to symptoms such as abdominal pain, vomiting, bloody diarrhea, lethargy, and in severe cases, seizures. It is important for individuals taking iron supplements to follow recommended dosages to prevent adverse effects.

3. A client in an acute mental health facility is experiencing withdrawal from Opioid use and has a new prescription for Clonidine. Which of the following actions should the nurse identify as the priority?

• A. Administer the clonidine on the prescribed schedule.
• B. Provide ice chips at the client's bedside.
• C. Educate the client on the effects of clonidine.
• D. Obtain baseline vital signs.

Correct answer: D

Rationale: In this scenario, the priority action for the nurse is to obtain baseline vital signs. This step is crucial in assessing the client's current physiological status and establishing a reference point for monitoring the effects of Clonidine. Administering the medication, providing ice chips, and educating the client are important tasks but assessing the client's vital signs takes precedence to ensure the client's safety and well-being during withdrawal management.

4. A drug ending in the suffix (tidine) is considered a ______.

• A. Antidepressant
• B. Protease inhibitor
• C. Beta antagonist
• D. H antagonist

Correct answer: D

Rationale: Drugs ending in -tidine are histamine (H2) receptor antagonists, which block the action of histamine at the H2 receptors, commonly used to reduce stomach acid production. Therefore, the correct answer is an 'H antagonist.' It is essential to be familiar with drug suffixes as they can provide clues to the drug's class and function.

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

• A. Apply the patch to the same site each day.
• B. Remove the patch at night.
• C. Cover the patch with a heating pad.
• D. Apply the patch to a hairless area of skin.

Correct answer: D

Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This ensures proper absorption of the medication. It is important to rotate the application site daily to prevent skin irritation and tolerance development. Applying the patch to the same site each day can lead to decreased efficacy and potential skin reactions. Removing the patch at night is not necessary as the patches are usually worn continuously to provide constant medication delivery. Covering the patch with a heating pad can increase the absorption of the medication and lead to an overdose, which is not recommended.

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