Nursing Elites

1. While a client is receiving the medication haloperidol, which client data would indicate to the practical nurse that the medication is therapeutic?

• A. The client has maintained consistent weight loss of 2 pounds per week.
• B. The client has demonstrated a decrease in paranoid behaviors.
• C. The client's blood pressure has remained within normal limits.
• D. The client's fasting blood glucose has remained below 120 mg/dL.

Correct answer: B

Rationale: When a client is taking haloperidol, a therapeutic response involves a decrease in symptoms such as paranoia, hallucinations, delusions, and emotional excitement. These improvements indicate that the medication is effectively managing the client's condition. Monitoring for a reduction in paranoid behaviors helps the practical nurse assess the medication's effectiveness in addressing the client's psychiatric symptoms.

2. A practical nurse (PN) is preparing to administer enoxaparin to a client. What is the most important action for the PN to take before administering this medication?

• A. Assess the client's blood pressure.
• B. Check the client's platelet count.
• C. Monitor the client's urine output.
• D. Review the client's blood glucose level.

Correct answer: B

Rationale: The correct answer is to check the client's platelet count. Enoxaparin can lead to thrombocytopenia (low platelet count), which can increase the risk of bleeding. Therefore, assessing the platelet count before administering enoxaparin is crucial to ensure that it is within a safe range. Assessing the client's blood pressure (Choice A) is not directly related to enoxaparin administration. Monitoring urine output (Choice C) and reviewing blood glucose levels (Choice D) are not essential actions before administering enoxaparin.

3. A client with a history of chronic kidney disease is prescribed epoetin alfa. The nurse should monitor for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Hyperglycemia
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Epoetin alfa can lead to hypertension as an adverse effect because it stimulates increased red blood cell production. This can result in elevated blood pressure levels, requiring careful monitoring by the nurse to prevent complications. Choice B, hypotension, is incorrect because epoetin alfa is more likely to cause hypertension rather than hypotension. Choice C, hyperglycemia, and Choice D, tachycardia, are also incorrect as they are not commonly associated with the use of epoetin alfa.

4. Prior to administration of the initial dose of the GI agent misoprostol, which information should the nurse obtain from the client?

• A. Taking an anti-emetic medication
• B. History of glaucoma
• C. Currently pregnant
• D. Allergy to aspirin

Correct answer: C

Rationale: The correct answer is C. It is crucial for the nurse to obtain information regarding the client's pregnancy status before administering misoprostol, as this medication is contraindicated in pregnancy due to its potential to cause uterine contractions. This can lead to serious complications such as miscarriage or premature birth. Therefore, assessing whether the client is currently pregnant is essential to ensure the safe administration of misoprostol. Choices A, B, and D are not directly related to the administration of misoprostol. While knowing if the client is taking an anti-emetic medication may be relevant to prevent drug interactions, a history of glaucoma and allergy to aspirin are not primary concerns before administering misoprostol.

5. A practical nurse (PN) is reviewing teaching with the client and/or significant others about the concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should the PN reinforce?

• A. Benztropine will reduce olanzapine's side effect of urinary retention.
• B. Benztropine potentiates the effect of olanzapine.
• C. Benztropine is used to control the side effects of olanzapine.
• D. The combined effect of these drugs will modify psychotic behavior.

Correct answer: C

Rationale: The correct answer is C because benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with olanzapine use. Choice A is incorrect because benztropine does not directly reduce olanzapine's side effect of urinary retention. Choice B is incorrect as benztropine does not potentiate the effect of olanzapine; its main role is to counteract extrapyramidal symptoms. Choice D is incorrect because the primary purpose of using benztropine alongside olanzapine is to manage side effects, not specifically to modify psychotic behavior.

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