Nursing Elites

1. A client with ulcerative colitis has been prescribed sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Jaundice
• B. Constipation
• C. Oral candidiasis
• D. Sedation

Correct answer: A

Rationale: The correct answer is A: Jaundice. Sulfasalazine can cause liver damage as a possible adverse effect, which can manifest as jaundice. Monitoring for jaundice is crucial to detect liver-related adverse effects early. Choices B, C, and D are incorrect. Constipation, oral candidiasis, and sedation are not typically associated with sulfasalazine use. Therefore, the nurse should focus on educating the client specifically about monitoring for jaundice.

2. A nurse is preparing to administer heparin 8,000 units subcutaneously every eight hours. The amount available is heparin injection 10,000 units/mL. How many milliliters should the nurse administer per dose? (Round the answer to the nearest tenth)

• A. 0.8 mL
• B. 0.9 mL
• C. 10.0 mL
• D. 98.0 mL

Correct answer: A

Rationale: To determine the volume of heparin to administer per dose, divide the prescribed dose (8,000 units) by the concentration of heparin available (10,000 units/mL). 8000 units / 10000 units/mL = 0.8 mL. Therefore, the nurse should administer 0.8 mL per dose. Choice B, 0.9 mL, is incorrect as the correct calculation results in 0.8 mL. Choices C and D are significantly higher and incorrect, indicating an inaccurate calculation.

3. A nurse is providing discharge teaching to a client who has heart failure and a new prescription for digoxin 0.215 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?

• A. I know that blurred vision is something I will expect to happen while taking digoxin.
• B. I will measure my urine output each day and document it in my diary.
• C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute.
• D. I will eat fruits and vegetables that have high potassium content every day.

Correct answer: D

Rationale: Clients taking digoxin and furosemide are at risk for hypokalemia. Eating potassium-rich foods can help maintain normal potassium levels.

4. A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication?

• A. Blood pressure
• B. Temperature
• C. Blood glucose levels
• D. Total protein levels

Correct answer: A

Rationale: The correct answer is A: Blood pressure. Epoetin alfa can increase blood pressure, especially in clients with chronic kidney failure. Monitoring blood pressure before administration is crucial to prevent hypertension. Reviewing temperature, blood glucose levels, or total protein levels is not directly related to the potential side effect of increased blood pressure associated with epoetin alfa.

5. A healthcare professional is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the healthcare professional should recognize that which of the following findings is a contraindication to the administration of diltiazem?

• A. Hypotension
• B. Tachycardia
• C. Decreased level of consciousness
• D. History of diuretic use

Correct answer: A

Rationale: Diltiazem, a calcium channel blocker, can cause hypotension. Administering it to a client who already has hypotension could exacerbate this condition. Therefore, hypotension is a contraindication to the administration of diltiazem. Incorrect Choices: B) Tachycardia is not a contraindication for administering diltiazem in atrial fibrillation as it is commonly used to control the heart rate. C) Decreased level of consciousness may require evaluation but is not a direct contraindication to diltiazem administration. D) History of diuretic use is not a contraindication if the client is not currently experiencing hypotension.

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