Nursing Elites

1. A male client recently started taking Haloperidol. Which of the following findings is the highest priority to report to the provider?

• A. Shuffling gait
• B. Neck spasms
• C. Drowsiness
• D. Impotence

Correct answer: B

Rationale: Neck spasms are an indication of acute dystonia, a serious side effect of Haloperidol that can quickly progress to a crisis situation. Immediate medical attention is necessary to prevent complications. Shuffling gait and drowsiness are common side effects of Haloperidol but are not as urgent as neck spasms. Impotence is not typically associated with Haloperidol use. Therefore, identifying neck spasms as the priority finding is crucial for the client's safety.

2. A client has been prescribed an ACE Inhibitor for hypertension. Which of the following instructions should be included by the healthcare provider?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Avoid foods high in potassium.
• D. Limit your fluid intake.

Correct answer: A

Rationale: The correct answer is to 'Avoid salt substitutes.' ACE Inhibitors can increase potassium levels, so clients should avoid salt substitutes that contain potassium to prevent hyperkalemia, which is a potential side effect of ACE Inhibitors. Choice B 'Take this medication at bedtime' is incorrect as ACE Inhibitors are usually taken in the morning to avoid nocturnal diuresis. Choice C 'Avoid foods high in potassium' is incorrect because although ACE Inhibitors can increase potassium levels, clients are generally encouraged to consume potassium-rich foods in moderation unless contraindicated. Choice D 'Limit your fluid intake' is also incorrect as ACE Inhibitors do not typically require fluid restrictions unless specified by a healthcare provider for other reasons.

3. A client in the operating room received a dose of Succinylcholine, leading to muscle rigidity and a sudden rise in body temperature. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: C

Rationale: Muscle rigidity and a sudden rise in temperature are indicative of malignant hyperthermia, a potential complication of succinylcholine. Dantrolene is the drug of choice to treat malignant hyperthermia as it acts on skeletal muscles to reduce metabolic activity and counteract the symptoms. Neostigmine (Choice A) is used to reverse the effects of non-depolarizing neuromuscular blocking agents, not for malignant hyperthermia. Naloxone (Choice B) is an opioid antagonist used for opioid overdose. Vecuronium (Choice D) is a non-depolarizing neuromuscular blocking agent and is not the appropriate medication for malignant hyperthermia.

4. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist, such as albuterol, and an inhaled glucocorticoid, such as beclomethasone, for asthma control, the beta2-agonist should be administered first. This sequence is important because the beta2-agonist promotes bronchodilation, which enhances the absorption and effectiveness of the glucocorticoid. Instructing the client to administer the albuterol inhaler before using the beclomethasone inhaler ensures optimal therapeutic benefit. Therefore, option B is the correct choice. Option A is incorrect because the timing of albuterol administration may vary based on the prescribed regimen. Option C is incorrect because beclomethasone is a controller medication, not a rescue medication, and should not be used during acute episodes. Option D is incorrect because beclomethasone should be shaken before use to ensure proper dispersion of the medication.

5. A client presents in the Emergency Department with chest pain. Which of the following conditions is least likely to cause chest pain?

• A. Arthritis
• B. Peptic ulcer disease
• C. Myocardial infarction
• D. Gastric reflux

Correct answer: A

Rationale: Arthritis is a condition primarily affecting the joints and is not known to cause chest pain. Peptic ulcer disease, myocardial infarction, and gastric reflux are conditions that can present with chest pain due to various reasons such as inflammation, ischemia, or reflux of stomach acid into the esophagus, respectively.

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