Nursing Elites

1. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: The correct answer is B: Fever. Fever is a key symptom of serotonin syndrome, a potentially life-threatening condition that can occur with the use of serotonergic medications like Sertraline. Serotonin syndrome is characterized by a combination of symptoms, including fever, agitation, rapid heartbeat, sweating, shivering, tremors, and in severe cases, it can lead to seizures, coma, and even death. Bruising (Choice A), abdominal pain (Choice C), and rash (Choice D) are not typically associated with serotonin syndrome. Therefore, the nurse should be vigilant in monitoring for fever as an early sign of serotonin syndrome in clients taking Sertraline.

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

• A. Take this medication with food.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Increase your intake of sodium-rich foods.

Correct answer: C

Rationale: Captopril should be taken on an empty stomach for better absorption. The client should be instructed to take it 1 hour before or 2 hours after meals to optimize its effectiveness. Taking it with food can reduce its absorption and efficacy.

3. A healthcare provider is reviewing the health history of a client who has a prescription for Propranolol. Which of the following findings should the provider report?

• A. Previous history of thromboembolism
• B. Concurrent use of an antacid
• C. History of bronchial asthma
• D. Recent weight gain

Correct answer: C

Rationale: Propranolol is a nonselective beta-blocker that can cause bronchoconstriction, making it contraindicated for clients with a history of bronchial asthma. Reporting a history of bronchial asthma to the provider is crucial as it would prompt a review of the medication prescription to avoid potential adverse effects and consider alternative treatment options.

4. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

5. A client is prescribed an IM dose of penicillin. She reports developing a rash after taking penicillin 3 years ago. What action should the healthcare professional take?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. It is crucial to report any past allergic reactions to medications, as this information guides the provider in prescribing a safe alternative. Administering the prescribed dose without considering the client's history of developing a rash can lead to potentially severe adverse reactions. Changing the prescription to an oral form or administering an oral antihistamine does not address the risk of an allergic reaction to penicillin in this case.

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