Nursing Elites

1. A client has a new prescription for Enoxaparin. Which of the following instructions should the nurse include?

• A. Massage the injection site after administration.
• B. Aspirate before injecting the medication.
• C. Administer the medication into the abdomen.
• D. Administer the medication via intramuscular injection.

Correct answer: C

Rationale: The correct answer is to administer the medication into the abdomen. Enoxaparin is a medication that is administered subcutaneously, typically in the abdomen to ensure proper absorption. Massaging the injection site should be avoided as it can lead to bruising or bleeding under the skin. Aspirating before injecting the medication is not necessary for subcutaneous injections like Enoxaparin. Administering the medication via intramuscular injection is incorrect as Enoxaparin should be given subcutaneously.

2. 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.

3. A client has a new prescription for Clonidine. Which of the following instructions should the nurse include?

• A. Expect to feel drowsy.
• B. Increase your intake of high-potassium foods.
• C. Take the medication with grapefruit juice.
• D. Avoid foods high in fat.

Correct answer: A

Rationale: The correct answer is to expect to feel drowsy. Clonidine is known to cause drowsiness, especially at the beginning of treatment. It is important for clients to be cautious with activities that require alertness until they understand how the medication affects them. Choice B is incorrect as there is no specific need to increase high-potassium foods with Clonidine. Choice C is incorrect as grapefruit juice can interact with many medications but is not a typical instruction for Clonidine. Choice D is incorrect as there is no specific indication to avoid foods high in fat with Clonidine.

4. A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?

• A. Cefaclor
• B. Cefazolin
• C. Cefepime
• D. Cephalexin

Correct answer: C

Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.

5. A client is prescribed Clopidogrel. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication, so monitoring the client's platelet count is crucial to assess for potential bleeding complications. Changes in platelet count can indicate an increased risk of bleeding, a known adverse effect of Clopidogrel. Monitoring white blood cell count, hemoglobin, or blood glucose is not directly related to the potential adverse effects of Clopidogrel and would not provide relevant information regarding the medication's impact on platelet function.

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