Nursing Elites

1. A healthcare professional is preparing to administer Pamidronate to a client who has bone pain related to cancer. Which of the following precautions should the healthcare professional take when administering pamidronate?

• A. Inspect the IV site for redness and irritation when changing the intravenous patch.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to sit upright or stand for 30 min following intravenous administration.
• D. Watch for manifestations of anaphylaxis for 20 min after intramuscular administration.

Correct answer: B

Rationale: Pamidronate is administered through intravenous (IV) infusion. As this medication can be irritating to veins, the healthcare professional should carefully assess the IV site for thrombophlebitis during administration to prevent potential complications. Choice A is incorrect as Pamidronate is not administered via intradermal patch. Choice C is incorrect as it does not relate to the administration of Pamidronate. Choice D is incorrect as Pamidronate is not administered intramuscularly.

2. A healthcare professional is preparing to administer heparin 15,000 units subcutaneously every 12 hours. The available heparin injection is 20,000 units/mL. How many milliliters should the healthcare professional administer per dose?

• A. 0.8 mL
• B. 0.75 mL
• C. 0.5 mL
• D. 1 mL

Correct answer: A

Rationale: To calculate the volume to administer, use the formula: Desired dose / Concentration = Volume to administer. In this case, (15,000 units / 20,000 units/mL) = 0.75 mL. Since the volume needs to be rounded up to the nearest tenth, the correct answer is 0.8 mL. Choice B (0.75 mL) is incorrect because it does not account for rounding up the volume. Choices C (0.5 mL) and D (1 mL) are incorrect as they do not reflect the precise calculation based on the given concentration and desired dose.

3. A client is reviewing a new prescription for Terbutaline with a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

• A. I can increase my activity now that I've started on this medication.
• B. I will increase my daily fluid intake to 3 quarts.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider as these are signs of preterm labor. Monitoring contractions is crucial for the management of preterm labor and the safety of both the client and the fetus. Choices A, B, and D are incorrect because increasing activity, fluid intake, or assuming the medication will prevent preterm labor do not address the essential need to report changes in contractions, which are a vital sign of potential complications in preterm labor.

4. A client has been prescribed Phenelzine for depression. Which of the following indicates that the client has developed an adverse effect of this medication?

• A. Orthostatic hypotension
• B. Hearing loss
• C. Gastrointestinal bleeding
• D. Weight loss

Correct answer: A

Rationale: Orthostatic hypotension is a known adverse effect of Phenelzine, a monoamine oxidase inhibitor (MAOI) used for depression. It is caused by a sudden drop in blood pressure when changing positions, leading to symptoms like dizziness or fainting. Monitoring for orthostatic hypotension is crucial during Phenelzine therapy to prevent complications. Choices B, C, and D are incorrect because hearing loss, gastrointestinal bleeding, and weight loss are not typically associated with Phenelzine use.

5. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers, such as the one the client received. It works by inhibiting the breakdown of acetylcholine, thereby enhancing neuromuscular transmission and reversing muscle weakness caused by the neuromuscular blocking agent.

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