Nursing Elites

1. A child is hospitalized with a diagnosis of lead poisoning. The healthcare provider assisting in caring for the child would prepare to assist in administering which of the following medications?

• A. Activated charcoal
• B. Sodium bicarbonate
• C. Syrup of ipecac
• D. Dimercaprol (BAL in Oil)

Correct answer: D

Rationale: Dimercaprol (BAL in Oil) is a chelating agent indicated for lead poisoning. It works by binding to lead and facilitating its removal from the body. Activated charcoal is used for certain types of poisoning by adsorbing toxins, while sodium bicarbonate can be used to treat acidosis. Syrup of ipecac is no longer recommended for poison treatment due to potential risks.

2. The healthcare provider is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The healthcare provider consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?

• A. Pancreatitis
• B. Diabetes mellitus
• C. Myocardial infarction
• D. Chronic obstructive pulmonary disease

Correct answer: A

Rationale: Asparaginase is contraindicated in clients with a history of pancreatitis due to the risk of impairing pancreatic function and causing complications. Therefore, the healthcare provider should consult with the registered nurse to assess the client's history of pancreatitis before administering asparaginase.

3. A client is taking phenytoin (Dilantin) for seizure control, and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range?

• A. 5 to 10 mcg/mL
• B. 10 to 20 mcg/mL
• C. 20 to 30 mcg/mL
• D. 30 to 40 mcg/mL

Correct answer: B

Rationale: The correct therapeutic serum drug level range for phenytoin (Dilantin) is 10 to 20 mcg/mL. This range is considered optimal for seizure control while minimizing the risk of toxicity. Monitoring drug levels helps ensure that the client is within the therapeutic range for effective treatment.

4. Meperidine hydrochloride (Demerol) is prescribed for a client with pain. Which of the following would the nurse monitor for as a side effect of this medication?

• A. Diarrhea
• B. Bradycardia
• C. Hypertension
• D. Urinary retention

Correct answer: D

Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic that can cause various side effects. Common side effects include respiratory depression, orthostatic hypotension, tachycardia, drowsiness, constipation, and urinary retention. Diarrhea is not a common side effect of Meperidine hydrochloride. Bradycardia and hypertension are not typically associated with this medication. Therefore, the nurse should monitor for urinary retention as a potential side effect of Meperidine hydrochloride.

5. The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client?

• A. Paralytic ileus
• B. Incisional pain
• C. Urinary retention
• D. Nausea and vomiting

Correct answer: D

Rationale: Ondansetron, also known as Zofran, is an antiemetic medication primarily used to treat nausea and vomiting. In the postoperative setting, it is commonly administered to manage postoperative nausea and vomiting, which are frequent occurrences after surgery. Ondansetron works by blocking serotonin, a natural substance in the body that can trigger nausea and vomiting. It is also utilized to manage chemotherapy-induced nausea and vomiting. Therefore, the correct condition for which ondansetron should be administered to the postoperative client is nausea and vomiting.

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