Nursing Elites

1. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The healthcare provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

• A. Bursitis
• B. Sinusitis
• C. Depression
• D. Glaucoma

Correct answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Choosing option D, Glaucoma, as the correct answer is crucial for the client's safety and to prevent exacerbation of their eye condition. Options A, B, and C are not contraindications for Oxybutynin use and are unrelated to the pharmacological effects of this medication.

2. At what amount does Acetaminophen stop effectively controlling pain?

• A. Over 1,000 mg
• B. 750 mg
• C. Over 1,500 mg
• D. 150 mg

Correct answer: A

Rationale: Acetaminophen is known to lose its effectiveness in controlling pain beyond a dosage of 1,000 mg. Taking more than 1,000 mg will not provide additional pain relief but can increase the risk of adverse effects. Choice B (750 mg) is incorrect because this amount is within the typical recommended dose range for Acetaminophen. Choice C (Over 1,500 mg) is incorrect as it suggests a higher dose than the point at which Acetaminophen starts to lose its effectiveness. Choice D (150 mg) is too low a dose to effectively control pain for most adults.

3. A client has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a non-hairy area.
• B. Change the patch every 72 hours.
• C. Avoid exposure to heat sources.
• D. Do not cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction the nurse should include for a client using a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, potentially causing an overdose. Instructing the client to avoid heat sources is crucial to ensure their safety and the effectiveness of the medication. Choices A, B, and D are incorrect because applying the patch to a non-hairy area, changing it every 72 hours, and not cutting the patch are general guidelines for using transdermal patches but do not specifically address the unique risks associated with Fentanyl patches.

4. When reviewing facility policies for IV therapy with the team, a nurse manager should remind the team that which technique helps minimize the risk of catheter embolism?

• A. Performing hand hygiene before and after IV insertion
• B. Rotating IV sites at least every 72 hours
• C. Minimizing tourniquet time
• D. Avoiding reinserting the needle into an IV catheter

Correct answer: D

Rationale: Avoiding reinserting the needle into an IV catheter is crucial to minimizing the risk of catheter embolism. Reinserting the needle can lead to the severing of the catheter's end, potentially causing a catheter embolism, a serious complication. The other options, while important for IV therapy safety, are not directly related to preventing catheter embolism.

5. A healthcare provider is caring for a client who is prescribed Digoxin. Which of the following laboratory values should the provider monitor to assess for potential toxicity?

• A. Sodium
• B. Potassium
• C. Magnesium
• D. Calcium

Correct answer: B

Rationale: The correct answer is to monitor the client's potassium levels. Hypokalemia can increase the risk of Digoxin toxicity. Potassium levels should be closely monitored to prevent adverse effects. Monitoring sodium levels is not directly related to Digoxin toxicity. While magnesium and calcium are important electrolytes, potassium levels are more critical for Digoxin toxicity assessment.

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