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. When caring for a client prescribed Lithium, which laboratory value should the nurse monitor to assess for potential toxicity?

• A. Serum sodium
• B. Serum lithium
• C. Serum potassium
• D. Serum calcium

Correct answer: B

Rationale: The nurse should monitor the client's serum lithium levels to ensure they are within the therapeutic range and to assess for potential toxicity. Monitoring serum lithium levels is crucial because lithium has a narrow therapeutic range, and levels outside this range can lead to toxicity, which can be life-threatening. Therefore, regular monitoring is essential to prevent adverse effects and ensure the medication's effectiveness.

3. A client is being educated about the use of Fluticasone to treat Perennial Rhinitis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should use the spray every 4 hours while I am awake.
• B. It can take as long as 3 weeks before the medication takes maximum effect.
• C. This medication can also be used to treat motion sickness.
• D. I can use this medication when my nasal passages are blocked.

Correct answer: B

Rationale: The correct answer is B because Fluticasone may show some benefits within a few hours, but its full therapeutic effect may take up to 3 weeks to be achieved in treating Perennial Rhinitis. Option A is incorrect as the frequency of Fluticasone use is usually once daily. Option C is incorrect as Fluticasone is not used for motion sickness. Option D is incorrect as Fluticasone is a preventive medication and not used for immediate relief when nasal passages are blocked.

4. 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.

5. Which of the following conditions is not treated with Methotrexate?

• A. Sarcomas
• B. Leukemias
• C. Ectopic pregnancy
• D. Rheumatic fever

Correct answer: D

Rationale: The correct answer is D. Methotrexate is not typically used to treat rheumatic fever, which is more commonly managed with antibiotics to eradicate the underlying infection. Methotrexate is commonly used in the treatment of conditions like sarcomas, leukemias, and ectopic pregnancies due to its anti-inflammatory and anti-cancer properties.

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