Nursing Elites

1. A client has a new prescription for Timolol. How should the nurse instruct the client to insert eye drops?

• A. Press your finger on the inside corner of your eye for 1 minute after application.
• B. Apply the eye drops directly to the cornea.
• C. Drop the prescribed amount of medication into the center of the conjunctival sac.
• D. Wipe your eyes gently with a tissue immediately after application.

Correct answer: C

Rationale: When administering eye drops, it is essential to instruct the client to drop the prescribed amount of medication into the center of the conjunctival sac. This technique helps ensure proper distribution of the medication and reduces the risk of potential adverse effects. Pressing on the inside corner of the eye is done to prevent systemic absorption, applying drops directly to the cornea can cause irritation, and wiping the eyes after application can lead to decreased effectiveness of the medication.

2. A healthcare provider is preparing to administer Belimumab to a client with Systemic Lupus Erythematosus. Which of the following actions should the healthcare provider plan to take?

• A. Warm the medication to room temperature before administering.
• B. Administer the medication by IV bolus over 5 minutes.
• C. Dilute the medication in a 5% dextrose and water solution.
• D. Monitor the client for hypersensitivity reactions.

Correct answer: D

Rationale: Correct Answer: Monitoring the client for hypersensitivity reactions is crucial when administering Belimumab due to its known potential for severe infusion reactions and anaphylaxis. The healthcare provider should closely observe the client during the administration to promptly identify and manage any hypersensitivity reactions that may occur. Choice A is incorrect because warming Belimumab is not necessary before administration. Choice B is incorrect as Belimumab should not be administered as an IV bolus over 5 minutes; it should be given as an IV infusion over a longer duration. Choice C is incorrect as Belimumab should not be diluted in a 5% dextrose and water solution.

3. A client has a new prescription for Bisacodyl. Which of the following statements should the nurse include?

• A. Take the medication before bedtime.
• B. Expect a rapid heart rate.
• C. Increase your intake of high-sodium foods.
• D. Expect rectal burning with the suppository form.

Correct answer: D

Rationale: The correct statement to include when educating a client about Bisacodyl is to expect rectal burning with the suppository form. Bisacodyl, a stimulant laxative, is known to cause rectal burning when administered as a suppository. This side effect is common and expected, and it is important for the client to be aware of it to prevent unnecessary alarm or concern. Choices A, B, and C are incorrect. Taking Bisacodyl before bedtime is not a common instruction; expecting a rapid heart rate is not a typical side effect of Bisacodyl; and increasing intake of high-sodium foods is not related to the use of Bisacodyl.

4. When assessing a client taking Lithium Carbonate for Bipolar disorder, which finding should the nurse recognize as a possible indication of toxicity to this medication?

• A. Severe hypertension
• B. Coarse tremors
• C. Constipation
• D. Muscle spasm

Correct answer: B

Rationale: The correct answer is B: Coarse tremors. Coarse tremors are a common sign of Lithium toxicity. Monitoring for tremors is crucial as they can indicate a potentially serious complication that requires immediate intervention. While other options such as severe hypertension, constipation, and muscle spasm may be symptoms of various conditions, they are not typically associated with Lithium toxicity. Severe hypertension is not a common sign of Lithium toxicity; constipation is not a typical symptom of Lithium toxicity either, and muscle spasm is not a direct indicator of Lithium toxicity.

5. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?

• A. Uroprotectant agent, such as mesna
• B. Opioid, such as morphine
• C. Loop diuretic, such as furosemide
• D. H1 receptor antagonist, such as diphenhydramine

Correct answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

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