Nursing Elites

1. A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?

• A. Initiate a second intravenous access site
• B. Prepare to initiate cardiopulmonary resuscitation
• C. Determine the results of the drug toxicity screen
• D. Administer an additional dose of naloxone

Correct answer: D

Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.

2. What class of laxative would the nurse recommend to a patient asking about the best way to prevent constipation?

• A. Stimulant laxatives
• B. Bulk-forming laxatives
• C. Emollient laxatives
• D. Hyperosmotic laxatives

Correct answer: B

Rationale: The correct answer is B: Bulk-forming laxatives. These laxatives are recommended to prevent constipation because they work by absorbing liquid in the intestines, forming a bulky, soft stool that is easier to pass. They are safe and considered the most natural option. Stimulant laxatives (choice A) work by promoting bowel movements through intestinal contractions and are more suitable for treating occasional constipation rather than preventing it. Emollient laxatives (choice C) soften the stool by increasing the incorporation of water into the feces and are more suitable for patients who need to avoid straining during defecation. Hyperosmotic laxatives (choice D) work by drawing water into the intestine through osmosis and are typically used for more severe cases of constipation, not for prevention.

3. The practical nurse (PN) is obtaining the medical history of a client starting a new prescription for conjugated estrogens PO daily. Which medical condition is not treated by this medication?

• A. Menopausal symptoms
• B. Prostatic cancer
• C. Thromboembolic diseases
• D. Abnormal uterine bleeding

Correct answer: C

Rationale: Conjugated estrogens, such as Premarin, are not used in the treatment of thromboembolic diseases. These medications are contraindicated in conditions predisposing to thromboembolic diseases due to their association with an increased risk of thromboembolism, stroke, pulmonary embolism, and myocardial infarction. Choices A, B, and D are incorrect because conjugated estrogens are commonly prescribed for managing menopausal symptoms, abnormal uterine bleeding, and certain hormone-responsive cancers, but not for thromboembolic diseases.

4. A client has sublingual nitroglycerine tablets prescribed to treat angina. The nurse realizes the client requires further education if the client makes which statements? (Select one that doesn't apply.)

• A. I will need to replace the nitroglycerine tablets every 3 to 5 months, not in a year.
• B. I should continue taking nitroglycerine tablets if I develop a headache.
• C. I understand nitroglycerine tablets do not cause addiction.
• D. If I feel dizzy when I take these, I should sit down or lie down until I feel better.

Correct answer: D

Rationale: The correct answer is D. Nitroglycerine sublingual tablets need to be replaced every 3 to 5 months, not every year, making statement A incorrect. While nitroglycerine can cause a headache, it is important to continue taking the prescribed nitroglycerine if the client has angina, making statement B accurate. Nitroglycerine tablets do not cause addiction, so statement C is correct. Dizziness and weakness are associated with the hypotensive effect of nitroglycerine; therefore, if the client feels dizzy when taking them, they should sit down or lie down until they feel better. Taking nitroglycerine tablets before an activity known to cause angina can help prevent angina attacks.

5. A client is receiving levothyroxine for hypothyroidism. The nurse should monitor the client for which potential side effect?

• A. Weight gain
• B. Dry skin
• C. Hair loss
• D. Hyperthermia

Correct answer: A

Rationale: Levothyroxine is a medication used to treat hypothyroidism by supplementing the body with thyroid hormone. If the dosage of levothyroxine is too high, it can cause symptoms of hyperthyroidism, including weight loss. Therefore, weight gain can be a potential side effect of levothyroxine if the dosage is excessive.

Similar Questions