Nursing Elites

1. A client has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a non-hairy area.
• B. Change the patch every 72 hours.
• C. Avoid exposure to heat sources.
• D. Do not cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction the nurse should include for a client using a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, potentially causing an overdose. Instructing the client to avoid heat sources is crucial to ensure their safety and the effectiveness of the medication. Choices A, B, and D are incorrect because applying the patch to a non-hairy area, changing it every 72 hours, and not cutting the patch are general guidelines for using transdermal patches but do not specifically address the unique risks associated with Fentanyl patches.

2. How should a client prevent systemic absorption of Timolol eye drops according to the nurse's instructions?

• A. Bony orbit
• B. Nasolacrimal duct
• C. Conjunctival sac
• D. Outer canthus

Correct answer: B

Rationale: The correct technique to prevent systemic absorption of eye drops is to press on the nasolacrimal duct while instilling them. By doing so, the lacrimal punctum gets temporarily blocked, reducing drainage into the nasolacrimal duct and systemic circulation. This method helps enhance the localized effect of the medication and decreases the risk of systemic side effects. Choices A, C, and D are incorrect as they do not play a direct role in preventing systemic absorption of the eye drops.

3. When completing a nursing history for a client taking Simvastatin, which of the following disorders should the nurse identify as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in clients with active moderate-to-severe liver disorders, particularly if they are already on a statin like simvastatin. Hepatitis C is a liver condition that can be exacerbated by Ezetimibe, leading to potential complications. Therefore, the nurse should identify active hepatitis C as a contraindication to adding Ezetimibe to the client's medications. Choices A, B, and D are incorrect because they are not directly related to the contraindication of Ezetimibe in clients taking Simvastatin.

4. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

5. When educating a patient on taking levothyroxine, a drug used to balance thyroid activity, what should you include in their education?

• A. Don't disregard side effects and consult your healthcare professionals
• B. Take this at the same time every day
• C. Thyroid tests are necessary while taking this drug
• D. It is not recommended to take this drug if you have recently had a myocardial infarction

Correct answer: B

Rationale: The correct answer is to take levothyroxine at the same time every day. Consistent timing helps maintain stable thyroid levels, ensuring the effectiveness of the medication. It is important to establish a routine to optimize its therapeutic benefits. Choice A is incorrect as patients should not ignore side effects but should consult healthcare professionals if they experience any. Choice C is incorrect because thyroid tests may still be necessary to monitor thyroid function while on levothyroxine. Choice D is incorrect as it is not advisable to take levothyroxine if the patient has recently had a myocardial infarction without consulting their healthcare provider.

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