Nursing Elites

1. A client is receiving Morphine IV for pain management. Which of the following actions should the nurse take?

• A. Monitor the client's respiratory rate every 15 minutes.
• B. Monitor the client's blood pressure every 30 minutes.
• C. Monitor the client's oxygen saturation every hour.
• D. Monitor the client's heart rate every 5 minutes.

Correct answer: A

Rationale: The correct action for the nurse is to monitor the client's respiratory rate every 15 minutes while on Morphine IV to promptly detect respiratory depression, a critical adverse effect associated with this medication. Respiratory depression is a common side effect of opioid medications like Morphine and can be life-threatening. Monitoring the respiratory rate frequently enables the nurse to identify early signs of respiratory compromise and intervene promptly. Monitoring other vital signs like blood pressure, oxygen saturation, or heart rate is important but not as crucial as monitoring respiratory rate when a client is on Morphine IV.

2. A healthcare professional reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the professional take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication, and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify trough levels of a medication, the healthcare professional should obtain a blood specimen immediately before administering the next dose of medication. This timing ensures an accurate representation of the medication's lowest concentration in the bloodstream, which is crucial for therapeutic monitoring and dose adjustments. Choice B is incorrect because waiting 24 hours after taking the medication would not provide an accurate trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect because obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level, as it is the lowest concentration before the next dose.

3. A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

• A. Increase the amount of dietary fiber in the diet.
• B. Drink grapefruit juice daily to increase vitamin C intake.
• C. Decrease the amount of calcium in the diet.
• D. Withhold food for 1 hr after taking the medication.

Correct answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of the medication. Dietary fiber can help maintain bowel regularity and alleviate constipation.

4. When teaching parents about a child newly prescribed Desipramine, the nurse should instruct them that which of the following adverse effects is the priority to report to the provider?

• A. Constipation
• B. Suicidal thoughts
• C. Photophobia
• D. Dry mouth

Correct answer: B

Rationale: The priority adverse effect to report when a child is prescribed Desipramine is suicidal thoughts. Desipramine can increase the risk of suicidal thoughts and behaviors. It is crucial for parents to monitor the child for any signs of worsening depression or thoughts of self-harm and report them promptly to the healthcare provider to prevent any harm to the child. Options A, C, and D are potential side effects of Desipramine but are not as urgent or life-threatening as suicidal thoughts, which require immediate intervention to ensure the safety of the child.

5. When reviewing a client's health record, a nurse notes a new prescription for Lisinopril 10 mg PO once daily. The nurse should identify this as which type of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates medications to be administered on a regular schedule without a termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily falls under a routine prescription, meaning the nurse will administer this medication daily until the provider discontinues it. Choices A, B, and D are incorrect: A 'single' prescription is for a one-time dose, 'stat' prescriptions are for immediate administration, and 'standing' prescriptions are pre-authorized for administration as needed within specified parameters.

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