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 with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.

3. A client has a new prescription for Metronidazole. Which of the following instructions should be included in the discharge teaching?

• A. Avoid drinking alcohol while taking this medication.
• B. Take this medication on an empty stomach.
• C. Avoid dairy products while taking this medication.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction to include in the discharge teaching for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Drinking alcohol with Metronidazole can result in a disulfiram-like reaction, leading to symptoms such as nausea, vomiting, and flushing. Therefore, it is crucial for the client to abstain from alcohol consumption during the course of treatment with Metronidazole.

4. A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?

• A. Use an electric shaver to remove excess hair on the extremity.
• B. Select the antecubital area to insert the IV catheter.
• C. Distend the veins by using a blood pressure cuff.
• D. Instruct the client to keep the extremity still during the procedure.

Correct answer: C

Rationale: Distending the veins using a blood pressure cuff is essential for facilitating visualization and access to the veins during IV catheter insertion. This technique helps healthcare professionals identify suitable veins, reducing the risk of complications like infiltration or hematoma formation. Using an electric shaver to remove hair on the extremity (Choice A) may increase the risk of micro-cuts and introduce infection. Selecting the antecubital area (Choice B) may not always be appropriate, as vein condition and accessibility vary among older adult clients. Instructing the client to keep the extremity still (Choice D) is important but is not directly related to preparing for IV therapy.

5. A client has a new prescription for Captopril to treat hypertension. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Avoid salt substitutes.
• C. Increase your intake of potassium-rich foods.
• D. Expect a dry cough to develop.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to advise the client to avoid salt substitutes. Salt substitutes often contain potassium, and captopril can cause hyperkalemia. By avoiding salt substitutes, the client can prevent elevated potassium levels and associated complications.

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