Nursing Elites

1. A client informs the nurse that she has difficulty swallowing tablets and struggles with liquid or chewable medications due to taste. What medication should the nurse request a prescription for when preparing to administer Penicillin V to treat the client's streptococcal infection?

• A. Fosfomycin
• B. Amoxicillin
• C. Nafcillin
• D. Cefaclor

Correct answer: C

Rationale: Nafcillin is an appropriate alternative within the penicillin class for clients who have difficulty swallowing tablets or struggle with liquid or chewable medications. It is available for intramuscular (IM) or intravenous (IV) administration, offering options beyond oral formulations. Fosfomycin, Amoxicillin, and Cefaclor are not suitable alternatives for Penicillin V in this scenario as they belong to different classes of antibiotics and may not be as effective in treating streptococcal infections.

2. A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

• A. Apply the patch to a different location each day.
• B. Remove the patch every night before bedtime.
• C. Massage the patch area gently after application.
• D. Shave the area before applying the patch.

Correct answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.

3. A client is receiving Morphine IV for pain management. Which of the following actions should the nurse take to monitor for adverse effects?

• A. Monitor the client's respiratory rate every 15 minutes.
• B. Monitor the client's blood pressure every 30 minutes.
• C. Monitor the client's oxygen saturation every hour.
• D. Monitor the client's heart rate every 5 minutes.

Correct answer: A

Rationale: The correct action for the nurse to monitor for adverse effects of Morphine IV is to check the client's respiratory rate every 15 minutes. Respiratory depression is a potentially life-threatening adverse effect of Morphine. Monitoring the respiratory rate frequently allows for early detection and intervention if needed. Monitoring blood pressure, oxygen saturation, or heart rate alone may not provide early signs of respiratory depression, which is a critical adverse effect of Morphine IV.

4. Hydrochlorothiazide is classified as a

• A. Anti-inflammatory
• B. Antiarrhythmic
• C. Diuretic
• D. Antifungal

Correct answer: C

Rationale: Hydrochlorothiazide is classified as a diuretic. Diuretics are medications that help the body get rid of excess salt and water by increasing urine production, reducing fluid retention, and lowering blood pressure. Option A, Anti-inflammatory, is incorrect because hydrochlorothiazide does not primarily reduce inflammation. Option B, Antiarrhythmic, is incorrect because hydrochlorothiazide is not used to correct heart rhythm irregularities. Option D, Antifungal, is incorrect because hydrochlorothiazide is not used to treat fungal infections.

5. A client is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Monitoring blood pressure is crucial to detect and manage hypertension promptly. Leukocytosis refers to an increased white blood cell count and is not directly related to epoetin alfa treatment. Hyperkalemia is an elevated potassium level, which is not a common adverse effect of epoetin alfa. Fever is not a typical finding associated with epoetin alfa therapy.

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