Nursing Elites

1. When starting a new prescription for prednisone, which instruction should the nurse include for the client?

• A. Increase your intake of potassium-rich foods.
• B. Do not stop taking this medication abruptly.
• C. Avoid grapefruit juice while taking this medication.
• D. Take the medication at bedtime to prevent drowsiness.

Correct answer: B

Rationale: The correct instruction for a client starting a new prescription for prednisone is not to stop taking the medication abruptly. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, emphasizing the importance of gradual tapering under healthcare provider guidance. Increasing potassium-rich foods may be necessary based on individual needs, but it is not the priority instruction in this context. Grapefruit juice interaction is more commonly associated with certain medications but not specifically with prednisone. Taking prednisone at bedtime to prevent drowsiness is not a key instruction related to its administration.

2. A patient is prescribed acetaminophen 650 mg PO every 6 hr PRN for pain. The available acetaminophen liquid is 500 mg/5 mL. How many mL should the nurse administer per dose?

• A. 6.5 mL
• B. 7 mL
• C. 5 mL
• D. 8 mL

Correct answer: A

Rationale: To calculate the volume to administer: (Desired dose / Concentration) = Volume to administer. In this case, (650 mg / 500 mg) x 5 mL = 6.5 mL. Therefore, the nurse should administer 6.5 mL of acetaminophen liquid per dose to provide the prescribed 650 mg of acetaminophen. Choice B, 7 mL, is incorrect because the correct calculation results in 6.5 mL. Choice C, 5 mL, is incorrect as it is the concentration of the acetaminophen liquid, not the final volume needed. Choice D, 8 mL, is incorrect because it does not reflect the accurate calculation based on the prescription and concentration.

3. Which of the following is the antidote for Heparin toxicity?

• A. Protamine
• B. Methylene blue
• C. N-acetylcysteine
• D. Glucagon

Correct answer: A

Rationale: Protamine is the specific antidote for Heparin toxicity. Heparin is an anticoagulant medication, and if an overdose occurs or if there is excessive bleeding due to Heparin use, protamine, a positively charged molecule, can neutralize the anticoagulant effects of Heparin by forming a complex with it. This binding prevents Heparin from further inhibiting coagulation factors and helps in reversing its effects.

4. A healthcare professional is caring for a client who has a new prescription for Lisinopril. Which of the following laboratory values should the professional monitor?

• A. Serum potassium
• B. Serum sodium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing the excretion of potassium in the kidneys. Monitoring serum potassium levels is essential to prevent complications such as cardiac arrhythmias. Therefore, the healthcare professional should closely monitor the client's serum potassium levels when they are on Lisinopril. Choices B, C, and D are incorrect because Lisinopril primarily affects potassium levels due to its mechanism of action as an ACE inhibitor. Serum sodium, calcium, and magnesium levels are not typically affected by Lisinopril in the same way as potassium.

5. A healthcare provider is caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

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