Nursing Elites

1. A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

• A. Document that the client experienced an anaphylactic reaction to the medication.
• B. Change the IV infusion site.
• C. Decrease the infusion rate on the IV.
• D. Apply cold compresses to the neck area.

Correct answer: C

Rationale: Flushing and tachycardia are signs of Red Man Syndrome, which can be mitigated by decreasing the infusion rate.

2. A healthcare provider is completing a client's medical history. The client takes Simvastatin. The healthcare provider should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in patients with active moderate-to-severe liver disorders, such as active hepatitis C, especially when they are already taking a statin like simvastatin. This combination can increase the risk of liver problems and is not recommended due to the potential for further liver damage. Choices A, B, and D are not directly contraindications for adding Ezetimibe to the client's medications.

3. Why has an ACE inhibitor been prescribed following an MI?

• A. “This medication will lower your potassium level.”
• B. “ACE inhibitors have been found to reduce mortality following MI.”
• C. “ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI.”
• D. “This medication will treat your hypotension.”

Correct answer: B

Rationale: Following a myocardial infarction (MI), ACE inhibitors are commonly prescribed due to their proven benefit in reducing mortality and improving outcomes post-MI. These medications help by decreasing the workload of the heart, preventing remodeling of the heart chambers, and improving survival rates. While ACE inhibitors may have effects on potassium levels, the primary reason for their prescription post-MI is their mortality-reducing properties.

4. A client has a prescription for Levothyroxine. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: Levothyroxine should be taken on an empty stomach to increase absorption and efficacy. Taking it with food or antacids can interfere with its absorption, leading to reduced effectiveness of the medication.

5. A client receives a new prescription for NRTIs for HIV treatment. Which statement should the nurse include during teaching about these medications?

• A. These medications work by inhibiting enzymes to prevent HIV replication.
• B. These medications work by preventing protein synthesis within the HIV cell.
• C. These medications work by weakening the cell wall of the HIV virus.
• D. These medications work by blocking HIV entry into cells.

Correct answer: A

Rationale: NRTIs inhibit the enzyme reverse transcriptase, essential for HIV replication. By preventing this process, viral replication is hindered, ultimately reducing the viral load in the body. Option A correctly explains the mechanism of action of NRTIs in treating HIV infection. Choices B, C, and D describe mechanisms of action that do not align with how NRTIs work in HIV treatment. B is incorrect because NRTIs do not target protein synthesis within the HIV cell. C is incorrect as NRTIs do not affect the cell wall of the HIV virus. D is incorrect because NRTIs do not block HIV entry into cells.

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