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 Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?

• A. Vitamin K
• B. Calcium carbonate
• C. Acetaminophen
• D. Ranitidine

Correct answer: C

Rationale: The correct answer is Acetaminophen (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Vitamin K (Choice A) is actually used to reverse the effects of Warfarin in case of over-anticoagulation, so it does not increase the risk of bleeding. Calcium carbonate (Choice B) and Ranitidine (Choice D) do not significantly interact with Warfarin to increase the risk of bleeding.

3. A client is receiving daily doses of Oprelvekin. Which of the following laboratory values should be monitored to determine the effectiveness of this medication?

• A. Hemoglobin
• B. Absolute neutrophil count
• C. Platelet count
• D. Total white blood cell count

Correct answer: C

Rationale: Oprelvekin is a medication that stimulates platelet production. Therefore, monitoring the platelet count is essential to assess the effectiveness of this drug. The expected outcome for oprelvekin therapy is a platelet count greater than 50,000/mm^3. Changes in platelet count can indicate the response to the medication and help in adjusting the treatment plan accordingly. Monitoring hemoglobin, absolute neutrophil count, or total white blood cell count is not directly related to the mechanism of action of Oprelvekin and therefore would not provide accurate information on the drug's effectiveness.

4. A client has a new prescription for Hydralazine. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hyperglycemia
• C. Hyponatremia
• D. Constipation

Correct answer: A

Rationale: Corrected Rationale: Hydralazine is a vasodilator that can cause reflex tachycardia as an adverse effect. The client should monitor their pulse and report any significant increases, as tachycardia can indicate a severe adverse reaction to the medication. Choice B, Hyperglycemia, is not a common adverse effect of Hydralazine. Choice C, Hyponatremia, and Choice D, Constipation, are also not typically associated with Hydralazine use. Therefore, the correct answer is A: Tachycardia.

5. A healthcare provider is preparing to administer an IV bolus of Morphine to a client for pain management. Which of the following assessments is the healthcare provider's priority?

• A. Respiratory rate
• B. Pain level
• C. Blood pressure
• D. Level of consciousness

Correct answer: A

Rationale: The priority assessment for a healthcare provider preparing to administer an IV bolus of Morphine is the client's respiratory rate. Morphine can cause respiratory depression as a significant adverse effect, so monitoring the respiratory rate is crucial to detect any signs of respiratory compromise and intervene promptly. Assessing the respiratory rate takes precedence over other assessments because respiratory depression can lead to serious complications. While pain level, blood pressure, and level of consciousness are important assessments, they are not the priority when administering Morphine, as the risk of respiratory depression is a more immediate concern.

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