Nursing Elites

1. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.

2. While caring for a client receiving IV heparin, which of the following findings should the nurse identify as an adverse effect of this medication?

• A. Hypertension
• B. Hyperglycemia
• C. Thrombocytopenia
• D. Leukopenia

Correct answer: C

Rationale: Thrombocytopenia, a decrease in platelet count, is a known adverse effect associated with heparin therapy. It can lead to an increased risk of bleeding and should be closely monitored during treatment. Choices A, B, and D are incorrect. Hypertension is not typically associated with heparin use; hyperglycemia is not a common adverse effect of heparin; leukopenia is not a primary side effect of heparin therapy.

3. Which of the following is the antidote for lead poisoning?

• A. Naloxone
• B. Nitrite
• C. CaEDTA
• D. Dialysis

Correct answer: C

Rationale: Calcium disodium ethylenediaminetetraacetic acid (CaEDTA) is the antidote for lead poisoning. CaEDTA works by chelating lead, forming a complex that is then excreted in the urine. It is used in chelation therapy to treat lead poisoning by reducing lead levels in the body.

4. A client has a new prescription for Nifedipine. Which of the following adverse effects should the nurse monitor?

• A. Hypertension
• B. Edema
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Edema. Nifedipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should closely observe the client's lower extremities for any signs of swelling, which could indicate the development of edema. Choice A, Hypertension, is incorrect because Nifedipine is used to treat hypertension, not cause it. Choice C, Hyperglycemia, is unrelated to Nifedipine's common adverse effects. Choice D, Bradycardia, is not typically associated with Nifedipine use.

5. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.

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