Nursing Elites

1. After the initial dose, which of the following is the priority assessment for a client being treated for acute congestive heart failure with intravenously administered bumetanide?

• A. Monitoring weight loss
• B. Monitoring temperature
• C. Monitoring blood pressure
• D. Monitoring potassium level

Correct answer: C

Rationale: The correct answer is monitoring blood pressure. Bumetanide is a loop diuretic, and monitoring blood pressure is crucial as hypotension is a common side effect. Hypotension can further worsen the condition of a patient with congestive heart failure, so assessing and managing blood pressure is a priority after administering bumetanide.

2. The healthcare provider prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. What is the appropriate intervention for the nurse?

• A. Administer the medication within 60 minutes before the morning and evening meal.
• B. Withhold the medication and question the prescription with the healthcare provider.
• C. Monitor the client for gastrointestinal side effects after administration of the medication.
• D. Withdraw the insulin from the Penlet into an insulin syringe to prepare for administration.

Correct answer: B

Rationale: Exenatide (Byetta) is specifically indicated for the treatment of type 2 diabetes mellitus and is not recommended for clients with type 1 diabetes mellitus who are taking insulin. Choice A is incorrect because exenatide should not be administered to a client with type 1 diabetes mellitus who takes insulin. Choice C is not the most appropriate initial action when the prescription is not suitable for the client. Choice D is unrelated to the administration of exenatide. Therefore, the appropriate intervention for the nurse is to withhold the medication and question the prescription with the healthcare provider to ensure the safety and appropriateness of the treatment plan for the client.

3. The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:

• A. Acne
• B. Eczema
• C. Hair loss
• D. Herpes simplex

Correct answer: A

Rationale: Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.

4. Before administering Methylergonovine (Methergine) to a client with postpartum hemorrhage caused by uterine atony, the nurse checks which of the following as the important client parameter?

• A. Temperature
• B. Lochial flow
• C. Urine output
• D. Blood pressure

Correct answer: D

Rationale: Methylergonovine (Methergine) acts by stimulating uterine contractions and causing vasoconstriction. As vasoconstriction can potentially impact blood pressure, it is crucial to check the client's blood pressure before administering Methylergonovine to monitor for any hypertensive effects.

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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