Nursing Elites

1. A hospitalized client receiving IV heparin for a deep-vein thrombosis begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

• A. Vitamin K1
• B. Atropine
• C. Protamine
• D. Calcium gluconate

Correct answer: C

Rationale: In this scenario, the client is experiencing a serious complication of heparin therapy, likely due to heparin-induced thrombocytopenia. Protamine is the antidote for heparin and can reverse its anticoagulant effects. It is essential to administer protamine promptly to counteract the effects of heparin and manage the bleeding. Vitamin K1 is used to reverse the effects of warfarin, not heparin. Atropine is used to treat bradycardia or some types of poisoning. Calcium gluconate is used to manage hyperkalemia or calcium channel blocker toxicity, not to reverse heparin's effects.

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

• A. Take the medication with food.
• B. Monitor your blood pressure weekly.
• C. Notify your provider if you develop a persistent cough.
• D. Avoid using salt substitutes to prevent hyperkalemia.

Correct answer: C

Rationale: The correct answer is to instruct the client to notify the provider if they develop a persistent cough. A persistent cough is a common adverse effect of Captopril and other ACE inhibitors. It is essential for the client to inform their healthcare provider promptly if this side effect occurs, as it may indicate a potentially serious issue that needs medical attention.

3. A client has a new prescription for Etravirine, an NNRTI. Which of the following statements should the nurse include in teaching the client?

• A. Take this medication with food.
• B. Take this medication on an empty stomach.
• C. Take this medication at the same time every day.
• D. Take this medication at bedtime to prevent drowsiness.

Correct answer: C

Rationale: The correct statement the nurse should include in teaching the client is to take Etravirine at the same time every day. This ensures consistent blood levels and effectiveness of the medication. Consistent timing is essential to achieve optimal therapeutic effects and avoid missing doses. Choices A and B are incorrect because Etravirine should not necessarily be taken with or without food; it is more important to take it consistently. Choice D is incorrect as there is no need to take Etravirine at bedtime to prevent drowsiness.

4. A healthcare professional is educating a client who is starting therapy with topotecan. Which of the following findings should the professional instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The correct answer is C: 'Sore throat.' Clients starting therapy with topotecan should be instructed to report a sore throat because it can indicate an infection due to the immunosuppressive effects of the medication. Infections can be serious in clients undergoing chemotherapy, so early detection and treatment are crucial to prevent complications. Choices A, B, and D are incorrect because while they are potential side effects of topotecan, they are usually not as immediately concerning as a sore throat, which could signal a serious infection requiring prompt attention.

5. Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?

• A. 45 minutes to 18 hours
• B. 30 minutes to 12 hours
• C. 90 minutes to 36 hours
• D. 60 minutes to 24 hours

Correct answer: B

Rationale: Reteplase (Retavase) is a thrombolytic medication used in the treatment of myocardial infarction (MI). It is crucial to administer this drug within 30 minutes to 12 hours following the onset of symptoms to achieve optimal therapeutic effects and improve patient outcomes. Administering Reteplase within this time frame helps in restoring blood flow to the affected areas of the heart by dissolving blood clots, reducing myocardial damage, and potentially preventing further complications associated with MI.

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