Nursing Elites

1. A client has a new prescription for Furosemide. Which of the following instructions should be included?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and falls. Instructing the client to change positions slowly helps prevent these adverse effects by allowing the body to adjust to postural changes gradually, reducing the risk of significant blood pressure drops upon standing up quickly.

2. A healthcare professional is providing discharge instructions to a client who has a new prescription for Enoxaparin. Which of the following instructions should the healthcare professional include?

• A. Inject the medication into the muscle.
• B. Massage the injection site after administration.
• C. Rotate injection sites between the arms and thighs.
• D. Administer the medication in the abdomen.

Correct answer: D

Rationale: The correct instruction is to administer Enoxaparin in the abdomen as a subcutaneous injection. This method helps prevent bleeding complications associated with the medication. Massaging the injection site after administration should be avoided to reduce the risk of local irritation or bleeding. While rotating injection sites between the arms and thighs is a good practice for some medications, it is not recommended for Enoxaparin. Consistent administration in the abdomen ensures optimal absorption and helps avoid complications.

3. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. 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 priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.

4. A client is being taught about a new prescription for Celecoxib. Which of the following information should be included in the teaching?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The correct answer is A: 'Increases the risk for a myocardial infarction.' Celecoxib, a COX-2 inhibitor, increases the risk for a myocardial infarction due to its effect on suppressing vasodilation, which can lead to this adverse cardiovascular event. Choices B, C, and D are incorrect. Celecoxib does not decrease the risk of stroke, inhibit COX-1, or increase platelet aggregation. It's crucial for the nurse to educate the client about the increased risk for a myocardial infarction when taking Celecoxib and emphasize monitoring for signs of heart issues and the importance of seeking prompt medical attention if symptoms occur.

5. What is the action of Nitroglycerin?

• A. Dilates the Bronchi
• B. Reduces Blood Glucose
• C. Reduces Nausea
• D. Dilates Coronary Arteries

Correct answer: D

Rationale: Nitroglycerin acts by dilating the coronary arteries, leading to increased blood flow and oxygen supply to the heart. This helps in relieving angina symptoms by reducing the heart's workload and improving blood supply to the myocardium. Choices A, B, and C are incorrect because Nitroglycerin's primary action is not related to dilating bronchi, reducing blood glucose, or reducing nausea.

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