Nursing Elites

1. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?

• A. Inspect the skin for redness and irritation around the injection site.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to lie down for 30 minutes after oral administration.
• D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.

Correct answer: B

Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.

2. While caring for a client taking Propylthiouracil, for which of the following adverse effects should the nurse monitor?

• A. Bradycardia
• B. Insomnia
• C. Heat intolerance
• D. Weight loss

Correct answer: A

Rationale: When a client is taking Propylthiouracil, the nurse should monitor for bradycardia as it is an adverse effect of this medication. Propylthiouracil can lead to a decrease in heart rate, which is known as bradycardia. Monitoring for this adverse effect is crucial to ensure the client's safety and well-being while on this medication. The other options, such as insomnia, heat intolerance, and weight loss, are not commonly associated adverse effects of Propylthiouracil. Therefore, they are incorrect choices for monitoring while the client is on this medication.

3. A healthcare professional is planning to administer Morphine IV to a postoperative client. Which of the following actions should the healthcare professional take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea that occurs with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action the healthcare professional should take when administering Morphine IV to a postoperative client is to withhold the medication if the respiratory rate is less than 12/min. Respiratory depression is a common adverse effect of opioids like Morphine. Administering opioids when the respiratory rate is already compromised can further depress breathing, leading to life-threatening complications. Monitoring for seizures and confusion (Choice A) is not directly related to Morphine administration. Protecting the client's skin from severe diarrhea (Choice B) is not a common side effect of morphine. Administering Morphine via IV bolus (Choice D) should be done carefully but is not the most critical action in this scenario.

4. A healthcare provider is assessing a client who is taking levothyroxine. The healthcare provider should recognize that which of the following findings is a manifestation of levothyroxine overdose?

• A. Insomnia
• B. Constipation
• C. Drowsiness
• D. Hypoactive deep-tendon reflexes

Correct answer: A

Rationale: Insomnia is a common symptom of levothyroxine overdose due to excessive stimulation of the central nervous system. Levothyroxine is a thyroid hormone replacement medication, and an overdose can lead to hyperthyroidism symptoms, including insomnia. Constipation and drowsiness are not typically associated with levothyroxine overdose. Hypoactive deep-tendon reflexes are more indicative of hypothyroidism rather than an overdose of levothyroxine.

5. In the management of nausea due to gastroparesis in a client with Diabetes, which of the following medications may be prescribed?

• A. Lubiprostone
• B. Metoclopramide
• C. Bisacodyl
• D. Loperamide

Correct answer: B

Rationale: Metoclopramide, as a dopamine antagonist, is commonly prescribed to manage nausea and improve gastric motility in clients with diabetic gastroparesis. By enhancing gastric emptying, it can help alleviate symptoms like bloating and nausea associated with gastroparesis. Choice A, Lubiprostone, is primarily used to treat chronic idiopathic constipation and irritable bowel syndrome with constipation, not nausea due to gastroparesis. Choice C, Bisacodyl, is a stimulant laxative used for the treatment of constipation and bowel preparation before procedures, not for nausea associated with gastroparesis. Choice D, Loperamide, is an antimotility agent used to manage diarrhea, not nausea or gastric motility issues seen in gastroparesis.

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