Nursing Elites

1. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital, with a long half-life of 4 days, remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should administer phenobarbital once a day to maintain a consistent therapeutic effect without the need for multiple daily doses. Administering the medication more than once a day would not be necessary and could increase the risk of side effects or toxicity. Therefore, the correct answer is to administer phenobarbital once a day.

2. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Take off the nitroglycerin patch if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction is to remove the nitroglycerin patch each evening to prevent tolerance. This allows for a 10- to 12-hour nitrate-free period daily, reducing the risk of developing tolerance to nitroglycerin. Cutting the patch in half is not recommended because it can alter the dosing and absorption rate, leading to inadequate symptom control. Taking off the patch for a headache is not necessary as headaches are a common side effect that may improve with continued use. Applying a new patch every 48 hours is not correct as it may not provide continuous symptom relief for angina.

3. A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?

• A. Use a blood pressure cuff to distend the veins.
• B. Select the antecubital area to insert the IV catheter.
• C. Distend the veins by using a blood pressure cuff.
• D. Direct the client to lower his arm below his heart.

Correct answer: C

Rationale: The correct answer is C. The healthcare professional should distend the veins using a blood pressure cuff to make the veins more visible and accessible for IV catheter insertion. This technique helps reduce the risk of overfilling the vein, which can lead to complications such as hematoma formation. Choices A, B, and D are incorrect because while selecting the antecubital area is often appropriate for IV insertion in adults, the key action in this scenario is to distend the veins using a blood pressure cuff to facilitate the procedure.

4. A client with HIV is beginning therapy with zidovudine. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Fatigue
• B. Blurred vision
• C. Ringing in the ears
• D. Constipation

Correct answer: A

Rationale: Fatigue is a common adverse effect of zidovudine due to its impact on bone marrow, leading to anemia. Zidovudine is known to suppress bone marrow function, resulting in decreased production of red blood cells and subsequently causing fatigue due to anemia. Monitoring for fatigue is essential to ensure early detection and management of this adverse effect.

5. A healthcare professional is preparing to administer an IV antibiotic to a client who has a systemic infection. Which of the following actions should the professional take first?

• A. Administer an antihistamine prior to the antibiotic.
• B. Monitor the client's urine output.
• C. Check the client's allergy history.
• D. Assess the client's vital signs.

Correct answer: C

Rationale: The first action the healthcare professional should take is to check the client's allergy history before administering the antibiotic to prevent a potential allergic reaction. It is crucial to identify any known allergies to antibiotics to ensure the client's safety and well-being. Administering an antihistamine prior to the antibiotic (Choice A) is not recommended unless an allergic reaction occurs. Monitoring the client's urine output (Choice B) and assessing the client's vital signs (Choice D) are important but not the first step in this situation. Checking the client's allergy history takes precedence to prevent adverse reactions.

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