Nursing Elites

1. A client has a new diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?

• A. Colchicine
• B. Hydroxychloroquine
• C. Auranofin
• D. Duloxetine

Correct answer: D

Rationale: The correct answer is D, Duloxetine. Duloxetine is a serotonin-norepinephrine reuptake inhibitor commonly used to manage fibromyalgia. It helps in reducing pain and improving mood in individuals with this condition. Colchicine (Choice A) is primarily used to treat gout, while Hydroxychloroquine (Choice B) and Auranofin (Choice C) are medications used to manage conditions like rheumatoid arthritis and lupus, not fibromyalgia.

2. A client is prescribed Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication with food.
• B. Store the medication in a cool, dry place.
• C. Swallow the tablets whole.
• D. Take one tablet every 5 minutes up to three doses for chest pain.

Correct answer: D

Rationale: During a chest pain episode, the client should take one nitroglycerin tablet sublingually every 5 minutes up to a total of three doses. If chest pain persists after three doses, emergency medical attention should be sought. Nitroglycerin should not be swallowed but allowed to dissolve under the tongue for rapid absorption. Storing the medication in a cool, dry place helps maintain its effectiveness.

3. Which of the following is classified as a class IA Sodium Channel blocker?

• A. Quinidine
• B. Disopyramide
• C. Aminodarone
• D. Propafenone

Correct answer: A

Rationale: Quinidine is classified as a class IA sodium channel blocker. Class IA antiarrhythmics, like quinidine, work by blocking sodium channels and delaying repolarization. Propafenone, mentioned in the original rationale, is actually a class IC antiarrhythmic agent, not a class IA sodium channel blocker.

4. A client has a new prescription for Ondansetron for nausea and vomiting associated with chemotherapy. Which of the following statements should the nurse include?

• A. Take this medication one hour before chemotherapy.
• B. You may experience a headache while taking this medication.
• C. Increase your intake of potassium while taking this medication.
• D. This medication may cause temporary hearing loss.

Correct answer: B

Rationale: The correct statement the nurse should include is that the client may experience a headache while taking Ondansetron. Headache is a common side effect of this medication, and clients need to be informed about this potential adverse reaction to enhance their understanding and management of side effects. The other statements are incorrect because Ondansetron is usually taken 30 minutes before chemotherapy, not one hour before (choice A). There is no specific need to increase potassium intake while taking Ondansetron (choice C), and temporary hearing loss is not a common side effect associated with this medication (choice D).

5. A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?

• A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
• C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• D. Draw a peak level at 0900 and a trough level at 2100.

Correct answer: C

Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.

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