Nursing Elites

1. A client is receiving IV Dopamine for the treatment of shock. Which of the following findings indicates that the medication is effective?

• A. Increased heart rate
• B. Decreased blood pressure
• C. Increased urine output
• D. Decreased respiratory rate

Correct answer: C

Rationale: The correct answer is increased urine output. Dopamine increases cardiac output and improves renal perfusion, leading to increased urine output. This response indicates that the medication is effective in treating shock by enhancing renal function and perfusion. Choices A, B, and D are incorrect because an increased heart rate, decreased blood pressure, and decreased respiratory rate are not findings that indicate the effectiveness of IV Dopamine in treating shock.

2. A client is prescribed Omeprazole for managing heartburn. What information should the nurse include in the teaching?

• A. Take this medication at bedtime.
• B. This medication decreases the production of gastric acid.
• C. Take this medication 2 hours after eating.
• D. This medication can cause hyperkalemia.

Correct answer: B

Rationale: The correct answer is B. The nurse should educate the client that Omeprazole works by reducing the production of gastric acid through inhibiting the enzyme responsible for its production. This action helps in managing heartburn and related symptoms effectively. Choice A is incorrect because Omeprazole is usually taken before eating. Choice C is incorrect as Omeprazole is typically taken before a meal. Choice D is unrelated to Omeprazole, as it is not associated with causing hyperkalemia.

3. 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.

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

• A. Increase your intake of bran fiber.
• B. Monitor your heart rate before taking the medication.
• C. Take the medication with antacids.
• D. Avoid drinking orange juice.

Correct answer: B

Rationale: When a client is prescribed Digoxin, it is essential to monitor their heart rate before each dose. Changes such as a heart rate below 60 bpm should be reported to the healthcare provider promptly. This is crucial because Digoxin can affect heart rhythm, and monitoring the heart rate helps in identifying any potential issues early on.

5. A client with angina asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with Sildenafil?

• A. Aspirin
• B. Isosorbide
• C. Clopidogrel
• D. Atorvastatin

Correct answer: B

Rationale: Isosorbide is an organic nitrate used to manage angina. Concurrent use of sildenafil with organic nitrates, like isosorbide, is contraindicated due to the risk of fatal hypotension. It is essential for clients to avoid taking nitrate medications within 24 hours of using isosorbide to prevent serious complications.

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