Nursing Elites

1. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

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

• A. Apply the patch to the same site each day.
• B. Remove the patch at night.
• C. Cover the patch with a heating pad.
• D. Apply the patch to a hairless area of skin.

Correct answer: D

Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This ensures proper absorption of the medication. It is important to rotate the application site daily to prevent skin irritation and tolerance development. Applying the patch to the same site each day can lead to decreased efficacy and potential skin reactions. Removing the patch at night is not necessary as the patches are usually worn continuously to provide constant medication delivery. Covering the patch with a heating pad can increase the absorption of the medication and lead to an overdose, which is not recommended.

3. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The healthcare professional should administer IV Hydromorphone slowly over 5 minutes to reduce the risk of hypotension and respiratory depression. Rapid administration can lead to adverse effects due to its potency. Choice B is incorrect because Naloxone is used as an antidote for opioid overdose, not routinely administered with Hydromorphone. Choice C is important but not specific to the administration of Hydromorphone. Choice D is incorrect as Hydromorphone is intended for intravenous use, not subcutaneous injection.

4. A client asks a nurse about Feverfew. Which response should the nurse provide?

• A. It is used to treat skin infections.
• B. It can decrease the frequency of migraine headaches.
• C. It can lessen the nasal congestion in the common cold.
• D. It can relieve nausea of morning sickness during pregnancy.

Correct answer: B

Rationale: The correct response is B: 'It can decrease the frequency of migraine headaches.' Feverfew is known for reducing the frequency of migraine headaches, but it has not been proven to relieve an existing migraine headache. Choices A, C, and D are incorrect because Feverfew is not used to treat skin infections, lessen nasal congestion in the common cold, or relieve nausea of morning sickness during pregnancy.

5. What is the antidote for Heparin?

• A. Protamine sulfate
• B. Narcan
• C. Romazicon
• D. Naloxone

Correct answer: A

Rationale: The correct answer is A: Protamine sulfate. Heparin is an anticoagulant medication used to prevent blood clots. In cases of overdose or excessive bleeding due to Heparin, protamine sulfate is administered as the specific antidote. Protamine sulfate works by neutralizing Heparin's anticoagulant activity. Choices B, C, and D are incorrect. Narcan (Naloxone) is used to reverse opioid overdose, Romazicon (Flumazenil) is used to reverse benzodiazepine overdose, and Naloxone is also used to reverse opioid overdose but is not the antidote for Heparin.

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