Nursing Elites

1. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

• A. Discuss the importance of tapering medications when discontinuing medication
• B. Explain that the dose will need to be decreased during times of stress or infection
• C. Instruct the client to take medication on an empty stomach with a glass of water
• D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

2. The nurse writes a problem of “potential for complication related to ovarian hyperstimulation” for a client who is taking clomiphene (Clomid), an ovarian stimulant. Which intervention should be included in the plan of care?

• A. Instruct the client to delay intercourse until menses
• B. Schedule the client for frequent pelvic sonograms
• C. Explain that the infusion therapy will take 21 days
• D. Discuss that this may cause an ectopic pregnancy

Correct answer: B

Rationale: Frequent pelvic sonograms help monitor for ovarian hyperstimulation, a serious potential side effect of clomiphene. Instructing the client to delay intercourse until menses (Choice A) is not directly related to monitoring for ovarian hyperstimulation. Explaining the duration of infusion therapy (Choice C) is not relevant to monitoring for this specific complication. Discussing the risk of ectopic pregnancy (Choice D) is important, but it is not the most appropriate intervention for monitoring ovarian hyperstimulation.

3. Warfarin (Coumadin) is an anticoagulant and interferes with the action of:

• A. Platelets
• B. Vitamin K
• C. Calcium
• D. Vitamin B12

Correct answer: B

Rationale: The correct answer is B: Vitamin K. Warfarin inhibits the action of vitamin K, which is essential for blood clotting. By interfering with the production of certain clotting factors, warfarin helps prevent blood clots. Choices A, C, and D are incorrect because warfarin primarily affects the vitamin K-dependent clotting factors and not platelets, calcium, or vitamin B12.

4. Which of the following is a potential side effect associated with the use of nonsteroidal anti-inflammatory drugs?

• A. Stomach irritation and bleeding
• B. Stomatitis and esophagitis
• C. Impaired folate absorption
• D. Increased potassium excretion

Correct answer: A

Rationale: The correct answer is A: Stomach irritation and bleeding. Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause stomach irritation and bleeding due to their effects on gastric mucosa. Stomatitis and esophagitis (Choice B) are not typically associated with NSAID use. While NSAIDs may affect renal function, leading to fluid retention and edema, they do not directly cause increased potassium excretion (Choice D). Impaired folate absorption (Choice C) is not a common side effect of NSAIDs.

5. Protecting the rights and privacy of the patient and their family is a part of which of the following steps for determining and fulfilling the nursing care needs of the patient?

• A. Evaluation
• B. Planning
• C. Implementation
• D. Assessment

Correct answer: C

Rationale: In nursing care, implementation involves putting the nursing care plan into action. This step includes safeguarding the rights and privacy of the patient and their family by providing care in a respectful and confidential manner. Evaluation (A) is about assessing the effectiveness of the care provided. Planning (B) is the stage where specific interventions are designed. Assessment (D) is the initial step where data is collected to identify the patient's needs.

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