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 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.

3. A nurse is reviewing the laboratory values for a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take?

• A. Administer vitamin K
• B. Reduce the infusion rate
• C. Give the client a low-dose aspirin
• D. Request an INR

Correct answer: B

Rationale: An aPTT of 90 seconds is elevated, indicating a risk of bleeding due to excessive anticoagulation. The appropriate action is to reduce the infusion rate of heparin to prevent further complications. Administering vitamin K is not indicated for an elevated aPTT due to heparin therapy. Giving the client a low-dose aspirin can further increase the risk of bleeding when combined with heparin. Requesting an INR is not necessary for monitoring heparin therapy; aPTT is the more specific test for assessing heparin's therapeutic effect. Therefore, the correct action for the nurse to prepare to take is to reduce the infusion rate of heparin.

4. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

• A. Platelet count
• B. Electrolyte levels
• C. Thyroid function
• D. Liver function

Correct answer: D

Rationale: The correct answer is D: Liver function. Gemfibrozil can lead to hepatotoxicity, making it crucial to monitor liver function tests. Monitoring platelet count (choice A) is not specifically indicated for gemfibrozil. Electrolyte levels (choice B) and thyroid function (choice C) are not directly affected by gemfibrozil, so they are not the primary laboratory tests to monitor in this case.

5. A client with gout is prescribed allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects?

• A. Nausea
• B. Metallic taste
• C. Fever
• D. Drowsiness

Correct answer: C

Rationale: The correct answer is C: Fever. Fever can indicate a serious hypersensitivity reaction to allopurinol, known as allopurinol hypersensitivity syndrome, which can be severe and even life-threatening. Nausea and drowsiness are common side effects of allopurinol but not necessarily indications to discontinue the medication. Metallic taste is not typically associated with allopurinol use. Therefore, the nurse should emphasize to the client the importance of reporting any signs of fever promptly for further evaluation and management.

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