Nursing Elites

1. A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication?

• A. Blood pressure
• B. Temperature
• C. Blood glucose levels
• D. Total protein levels

Correct answer: A

Rationale: The correct answer is A: Blood pressure. Epoetin alfa can increase blood pressure, especially in clients with chronic kidney failure. Monitoring blood pressure before administration is crucial to prevent hypertension. Reviewing temperature, blood glucose levels, or total protein levels is not directly related to the potential side effect of increased blood pressure associated with epoetin alfa.

2. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?

• A. Increases blood pressure
• B. Prevents esophageal bleeding
• C. Decreases heart rate
• D. Reduces ammonia levels

Correct answer: D

Rationale: The correct answer is D: Reduces ammonia levels. Lactulose is used to reduce blood ammonia levels in clients with hepatic encephalopathy. Options A, B, and C are incorrect because lactulose does not have the therapeutic effect of increasing blood pressure, preventing esophageal bleeding, or decreasing heart rate.

3. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

• A. Stop taking the isoniazid for 3 days and the discoloration should go away.
• B. Rifampin can turn body fluids orange.
• C. I'll make an appointment for you to see the provider this afternoon.
• D. Isoniazid can cause bladder irritation.

Correct answer: B

Rationale: The correct answer is B: 'Rifampin can turn body fluids orange.' Rifampin is known to cause orange discoloration of body fluids, including urine. This side effect is harmless and does not indicate a need to stop the medication. Choice A is incorrect because stopping isoniazid will not resolve the orange urine discoloration caused by rifampin. Choice C is unnecessary at this point since the orange urine is a known side effect of rifampin and does not require an urgent provider visit. Choice D is incorrect because bladder irritation is not typically associated with isoniazid.

4. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

• A. Take hydrochlorothiazide as needed for edema.
• B. Check your weight once weekly.
• C. Take the hydrochlorothiazide on an empty stomach.
• D. Take the hydrochlorothiazide in the morning.

Correct answer: D

Rationale: The correct answer is to take hydrochlorothiazide in the morning. This medication is usually advised to be taken in the morning to prevent nocturia, which is excessive urination at night. Option A is incorrect because hydrochlorothiazide should be taken daily as prescribed, not as needed for edema. Option B is incorrect as monitoring weight weekly may not be specifically related to hydrochlorothiazide therapy. Option C is incorrect as hydrochlorothiazide does not need to be taken on an empty stomach.

5. A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching?

• A. Respiratory depression can occur within 7 minutes after the morphine is administered.
• B. The morphine will peak within a few minutes.
• C. Withhold the morphine if the client has a respiratory rate less than 16/min.
• D. Administer the morphine over 2 minutes.

Correct answer: A

Rationale: The correct answer is A because respiratory depression is a significant risk when administering morphine, and it can occur within 7 minutes after administration. This information is crucial for the nurse to recognize and respond promptly. Choice B is incorrect because the peak effect of morphine via IV bolus is typically reached within a few minutes, not specifically 10 minutes. Choice C is incorrect because withholding morphine based solely on a respiratory rate less than 16/min may not be appropriate without considering other factors such as pain level, oxygen saturation, and overall respiratory status. Choice D is incorrect because administering morphine over 2 minutes may not prevent respiratory depression if it occurs rapidly after administration. Nurses should be vigilant for signs of respiratory depression regardless of the administration duration.

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