Nursing Elites

1. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.

2. A client has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching?

• A. You should have a high-carbohydrate snack between meals and at bedtime.
• B. You are likely to develop hand tremors if you take this medication for a long period of time.
• C. You may experience temporary numbness of your mouth after each dose.
• D. You should have your white blood cell count monitored every week.

Correct answer: D

Rationale: Clozapine carries a risk for fatal agranulocytosis. To monitor for this serious adverse effect, it is crucial to check the client's white blood cell count weekly while they are on clozapine therapy.

3. What is the classification for the drug valproate?

• A. Anti-diabetic
• B. Anti-convulsant
• C. Anti-ulcer agent
• D. Anti-hypertensive

Correct answer: B

Rationale: Valproate is classified as an anticonvulsant. It is commonly used to treat epilepsy and bipolar disorder by stabilizing electrical activity in the brain. Therefore, the correct classification for valproate is as an anticonvulsant. Options A, C, and D are incorrect because valproate is not used to treat diabetes, ulcers, or hypertension.

4. A client is prescribed Ciprofloxacin and seeks guidance from a nurse. Which instruction should the nurse provide?

• 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 due to the interference of calcium with medication absorption. Taking Ciprofloxacin 1 hour before or 2 hours after consuming dairy products ensures optimal effectiveness. Choice A is incorrect because Ciprofloxacin is usually taken on an empty stomach or with a light meal, not necessarily with heavy meals. Choice C is incorrect as there is no specific instruction to take Ciprofloxacin at bedtime. Choice D is incorrect because there is no need to increase potassium-rich foods intake specifically related to Ciprofloxacin use.

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

• A. Take this medication only when chest pain occurs.
• B. Store the medication in a cool, dry place.
• C. Apply the patch to a different site each time.
• D. Avoid consuming alcohol while taking this medication.

Correct answer: C

Rationale: The correct instruction for the nurse to include is to advise the client to apply the Nitroglycerin patch to a different site each time. This is crucial to prevent skin irritation and ensure consistent absorption of the medication. Rotating application sites is important as it helps maintain the effectiveness of the treatment and reduces the risk of skin reactions. Choice A is incorrect because Nitroglycerin is often used prophylactically to prevent angina episodes rather than just for acute chest pain. Choice B is not relevant to the administration or effectiveness of the medication. Choice D, while generally a good recommendation, is not directly related to the administration of Nitroglycerin.

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