Nursing Elites

1. A healthcare professional is caring for a client who has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the healthcare professional perform first?

• A. Urine output
• B. Bowel sounds
• C. Pain level
• D. Respiratory rate

Correct answer: D

Rationale: The healthcare professional should prioritize assessing the client's respiratory rate because respiratory depression is a life-threatening adverse effect of Morphine. Monitoring the respiratory rate allows for early detection of potential complications and timely intervention to prevent harm. Assessing urine output, bowel sounds, and pain level are important but should come after ensuring the client's respiratory status is stable as it is the most critical assessment to prevent serious complications associated with opioid use.

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

• A. Take this medication at bedtime.
• B. Remain upright for 30 minutes after taking the medication.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to remain upright for 30 minutes after taking Alendronate. This medication can cause esophageal irritation, and maintaining an upright position for at least 30 minutes helps prevent complications such as esophagitis or esophageal ulcers. Choice A is incorrect because Alendronate should be taken in the morning on an empty stomach. Choice C is incorrect because Alendronate should be taken on an empty stomach, preferably 30 minutes before the first food, beverage, or medication of the day. Choice D is incorrect because while calcium intake is important, it is not a specific instruction related to taking Alendronate.

3. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

4. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

• A. Contact the provider if the heart rate is less than 60/min.
• B. Check the pulse rate for 30 seconds and multiply the result by 2.
• C. Increase the intake of sodium.
• D. Take with food if nausea occurs.

Correct answer: A

Rationale: The correct answer is A. It is crucial for clients on Digoxin to monitor their heart rate. A heart rate less than 60/min can indicate bradycardia, a potential side effect of Digoxin. Therefore, the client should be instructed to contact the provider if their heart rate is less than 60/min to prevent complications and receive appropriate management. Choices B, C, and D are incorrect. Checking the pulse rate for 30 seconds and multiplying by 2 is not specific to Digoxin administration. Increasing sodium intake is contraindicated as Digoxin can lead to sodium retention. Taking Digoxin with food if nausea occurs is not recommended as it may affect the drug's absorption.

5. A client has a new prescription for Furosemide. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypernatremia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Furosemide, a diuretic, commonly causes hyponatremia (low sodium levels) as it increases the excretion of sodium. The nurse needs to monitor the client for signs of hyponatremia, such as confusion, weakness, and muscle cramps, by checking electrolyte levels regularly. Choices A, C, and D are incorrect because hyperkalemia (choice A), hypernatremia (choice C), and hypercalcemia (choice D) are not typically associated with Furosemide use.

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