Nursing Elites

1. A healthcare provider plans to administer Morphine IV to a postoperative client. Which of the following actions should the provider take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea associated with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action for the provider is to withhold morphine if the client's respiratory rate is 12/min or less. Respiratory depression is a serious side effect of morphine and other opioids. Withholding the medication and informing the healthcare provider is essential to prevent further respiratory compromise in the client. Choices A, B, and D are incorrect because monitoring for seizures and confusion, protecting the client's skin from severe diarrhea, and administering morphine via IV bolus over 30 seconds or less are not the primary actions to ensure client safety when administering morphine IV. Respiratory status is crucial due to the risk of respiratory depression associated with opioid administration.

2. What symptoms should a patient taking Omeprazole report to the healthcare provider?

• A. Black, tarry stools
• B. Diarrhea
• C. Abdominal pain
• D. All of the above

Correct answer: D

Rationale: Patients taking Omeprazole should report black, tarry stools, diarrhea, or abdominal pain to the healthcare provider because these symptoms could indicate serious side effects associated with the medication. Black, tarry stools may suggest gastrointestinal bleeding, diarrhea can be a sign of a gastrointestinal infection or adverse drug reaction, and abdominal pain may indicate underlying issues that need attention. Choosing 'All of the above' is the correct answer as all these symptoms are important to report for proper evaluation and management.

3. When providing teaching to a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a side effect that affects the gums. It is crucial for the client to maintain good oral hygiene to prevent oral health complications. Choices A, B, and D are incorrect. While the timing of medication administration and dietary considerations are important, they are not directly related to preventing the specific side effect of gingival hyperplasia caused by Phenytoin.

4. What finding should a nurse monitor for as an adverse effect when a client has a new prescription for Spironolactone?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an increase in potassium levels. Hyperkalemia can be dangerous, causing muscle weakness and cardiac dysrhythmias. Monitoring potassium levels closely is crucial when a client is on Spironolactone. Hypoglycemia (choice B) is incorrect because Spironolactone does not typically affect blood glucose levels. Hypocalcemia (choice C) and hyponatremia (choice D) are also incorrect as Spironolactone's primary impact is on potassium levels.

5. When should a blood sample be obtained for a peak serum level of gentamicin when administered by IV infusion for 1 hour at 0900?

• A. 1000
• B. 1030
• C. 1100
• D. 1130

Correct answer: B

Rationale: The nurse should obtain the blood sample for the peak serum level at 1030. This timing allows for 30 minutes to elapse after the completion of the 1-hour IV infusion, which is the recommended window for obtaining the peak serum level of gentamicin.

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