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. A client with chronic kidney disease is prescribed darbepoetin alfa. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: The correct answer is A: Hypertension. Darbepoetin alfa, used to treat anemia in chronic kidney disease, can lead to hypertension as a side effect. This medication stimulates red blood cell production, which can increase blood pressure. Monitoring blood pressure regularly is crucial to detect and manage this potential adverse effect. Choices B, C, and D are incorrect because hypotension, hyperkalemia, and hyperglycemia are not commonly associated with darbepoetin alfa therapy in chronic kidney disease.

3. A practical nurse (PN) is preparing to administer a scheduled dose of furosemide to a client. Which laboratory value is most important for the PN to review before administering the medication?

• A. Serum calcium level
• B. Serum potassium level
• C. Serum sodium level
• D. Serum magnesium level

Correct answer: B

Rationale: The correct answer is to review the client's serum potassium level before administering furosemide. Furosemide, a loop diuretic, can lead to hypokalemia, making it crucial to assess potassium levels to prevent potential complications like cardiac arrhythmias associated with low potassium levels.

4. A client with type 2 diabetes mellitus is prescribed exenatide. The nurse should monitor for which potential adverse effect?

• A. Nausea
• B. Hypoglycemia
• C. Hyperglycemia
• D. Pancreatitis

Correct answer: A

Rationale: Exenatide, a medication commonly used in type 2 diabetes, is known to cause gastrointestinal side effects, such as nausea. Monitoring for nausea is essential as it can lead to decreased appetite and potential weight loss, affecting the nutritional status of the client. While hypoglycemia and hyperglycemia are important to monitor in diabetes management, they are not typically associated with exenatide use. Pancreatitis is a rare but serious adverse effect of exenatide, which requires immediate medical attention if suspected.

5. A client with a history of angina is prescribed amlodipine. The practical nurse (PN) should monitor the client for which adverse effect?

• A. Headache
• B. Peripheral edema
• C. Hyperglycemia
• D. Hypertension

Correct answer: B

Rationale: Amlodipine, a calcium channel blocker, commonly causes peripheral edema as an adverse effect. This is due to its vasodilation effects on blood vessels, leading to fluid accumulation in the extremities. Monitoring for peripheral edema is crucial to assess the client's response to amlodipine and ensure timely intervention if needed.

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