Nursing Elites

1. When administering medications to a 4-month-old infant, which of the following pharmacokinetic principles should be considered? (Select all that apply.)

• A. Infants have a more rapid gastric emptying time.
• B. Infants have immature liver function.
• C. Infants' blood-brain barrier is poorly developed.
• D. Infants have an increased ability to absorb topical medications.

Correct answer: B

Rationale: When administering medications to a 4-month-old infant, the pharmacokinetic principle to consider is that infants have immature liver function until 1 year of age. This requires medications metabolized by the liver to be administered in smaller dosages. While infants do have a more rapid gastric emptying time, immature liver function is a more critical pharmacokinetic consideration in this context. Additionally, although infants have a poorly developed blood-brain barrier, this relates more to pharmacodynamic effects rather than pharmacokinetic principles. The statement about infants having an increased ability to absorb topical medications is not directly related to pharmacokinetic principles, making choice B the correct answer.

2. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?

• A. Instruct the client to self-ambulate every 2 hours.
• B. Offer oral hygiene every 2 hours.
• C. Anticipate medication administration 2 hours prior to delivery.
• D. Monitor fetal heart rate every 2 hours.

Correct answer: B

Rationale: When a client is receiving IV Opioid analgesics during labor, the nurse should offer oral hygiene every 2 hours. Opioid analgesics can cause adverse effects like dry mouth, nausea, and vomiting. Providing oral hygiene care helps alleviate these symptoms and maintains the client's comfort and well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate during labor as mobility may be limited. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's needs and the progress of labor. Monitoring fetal heart rate every 2 hours is important during labor, but it is not specifically related to the client receiving IV Opioid analgesics.

3. When assessing a client taking Lithium Carbonate for Bipolar disorder, which finding should the nurse recognize as a possible indication of toxicity to this medication?

• A. Severe hypertension
• B. Coarse tremors
• C. Constipation
• D. Muscle spasm

Correct answer: B

Rationale: The correct answer is B: Coarse tremors. Coarse tremors are a common sign of Lithium toxicity. Monitoring for tremors is crucial as they can indicate a potentially serious complication that requires immediate intervention. While other options such as severe hypertension, constipation, and muscle spasm may be symptoms of various conditions, they are not typically associated with Lithium toxicity. Severe hypertension is not a common sign of Lithium toxicity; constipation is not a typical symptom of Lithium toxicity either, and muscle spasm is not a direct indicator of Lithium toxicity.

4. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

5. A healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?

• A. Warfarin
• B. Acetaminophen
• C. Ibuprofen
• D. Aspirin

Correct answer: D

Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.

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