Nursing Elites

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

• 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 to monitor for adverse effects of Morphine IV is to check the client's respiratory rate every 15 minutes. Respiratory depression is a potentially life-threatening adverse effect of Morphine. Monitoring the respiratory rate frequently allows for early detection and intervention if needed. Monitoring blood pressure, oxygen saturation, or heart rate alone may not provide early signs of respiratory depression, which is a critical adverse effect of Morphine IV.

2. A client is receiving treatment with bevacizumab. Which of the following findings should the nurse monitor?

• A. Hypertension
• B. Hypokalemia
• C. Hyperglycemia
• D. Hypocalcemia

Correct answer: A

Rationale: Corrected Rationale: Bevacizumab is known to potentially cause hypertension as a common adverse effect. The nurse should monitor the client's blood pressure regularly to detect and manage any elevations effectively. Choices B, C, and D are incorrect because bevacizumab is not typically associated with causing hypokalemia, hyperglycemia, or hypocalcemia. Therefore, monitoring for hypertension is the priority in this case.

3. A client asks a nurse about Feverfew. Which response should the nurse provide?

• A. It is used to treat skin infections.
• B. It can decrease the frequency of migraine headaches.
• C. It can lessen the nasal congestion in the common cold.
• D. It can relieve nausea of morning sickness during pregnancy.

Correct answer: B

Rationale: The correct response is B: 'It can decrease the frequency of migraine headaches.' Feverfew is known for reducing the frequency of migraine headaches, but it has not been proven to relieve an existing migraine headache. Choices A, C, and D are incorrect because Feverfew is not used to treat skin infections, lessen nasal congestion in the common cold, or relieve nausea of morning sickness during pregnancy.

4. When teaching a client with schizophrenia strategies to cope with anticholinergic effects of Fluphenazine, which of the following should the nurse suggest to minimize anticholinergic effects?

• A. Take the medication in the morning to prevent insomnia.
• B. Chew sugarless gum to moisten the mouth.
• C. Use cooling measures to decrease fever.
• D. Take an antacid to relieve nausea.

Correct answer: B

Rationale: The correct answer is B: 'Chew sugarless gum to moisten the mouth.' Chewing sugarless gum can help alleviate dry mouth, which is a common anticholinergic effect of Fluphenazine. Dry mouth can be uncomfortable and affect the client's oral health. Options A, C, and D are incorrect because they do not directly address anticholinergic effects. Taking the medication in the morning to prevent insomnia (Option A) is unrelated to anticholinergic effects. Using cooling measures to decrease fever (Option C) is not a common anticholinergic effect of Fluphenazine. Taking an antacid to relieve nausea (Option D) does not specifically target anticholinergic effects.

5. A client has Diabetes Mellitus, Pulmonary Tuberculosis, and a new prescription for Isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH?

• A. Ascorbic acid
• B. Pyridoxine
• C. Folic acid
• D. Cyanocobalamin

Correct answer: B

Rationale: Pyridoxine is administered with Isoniazid to prevent peripheral neuropathy, a common adverse effect of the drug. It is essential to provide this supplement to the client to minimize the risk of developing this adverse effect. Ascorbic acid (Vitamin C) is not typically given to prevent INH adverse effects. Folic acid and Cyanocobalamin are not commonly administered with INH for this purpose.

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