Nursing Elites

1. When teaching the family of a child with Cystic Fibrosis about a new prescription for Acetylcysteine, which information should the nurse include?

• A. Expect this medication to suppress your cough.
• B. Expect this medication to smell like rotten eggs.
• C. Expect this medication to cause euphoria.
• D. Expect this medication to turn your urine orange.

Correct answer: B

Rationale: The correct answer is B: 'Expect this medication to smell like rotten eggs.' Acetylcysteine contains sulfur, which gives it a characteristic rotten-egg odor. This odor is normal and expected when using this medication. Choices A, C, and D are incorrect because Acetylcysteine is not used to suppress cough, cause euphoria, or change urine color. Educating the family on the distinct smell of Acetylcysteine will help them understand its characteristics and alleviate concerns about the odor.

2. A client is receiving Enoxaparin for the prevention of deep vein thrombosis. Which of the following actions should the nurse take?

• A. Massage the injection site after administration.
• B. Administer the medication intramuscularly.
• C. Administer the medication into the subcutaneous tissue.
• D. Administer the medication into the deltoid muscle.

Correct answer: C

Rationale: Enoxaparin, a medication used for preventing deep vein thrombosis, should be administered into the subcutaneous tissue, typically in the abdomen. Administering the medication intramuscularly (Choice B) or into the deltoid muscle (Choice D) is incorrect because Enoxaparin is specifically formulated for subcutaneous administration. Massaging the injection site after administration (Choice A) is contraindicated as it may lead to tissue damage and affect the absorption of the medication. Therefore, the correct action is to administer the medication into the subcutaneous tissue as directed.

3. A client has a new prescription for erythromycin. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should take this medication with a full glass of water.
• B. I should avoid direct sunlight while taking this medication.
• C. I will take this medication on an empty stomach.
• D. I should take an antacid 30 minutes before taking this medication.

Correct answer: C

Rationale: The correct answer is C. Erythromycin should be taken on an empty stomach with a full glass of water to increase absorption. Taking it with a full glass of water (Choice A) is incorrect. Avoiding direct sunlight (Choice B) is not related to erythromycin use. Taking an antacid before the medication (Choice D) can interfere with its absorption.

4. A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?

• A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
• C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• D. Draw a peak level at 0900 and a trough level at 2100.

Correct answer: C

Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.

5. In an acute mental health facility, a patient experiencing opioid withdrawal has a new prescription for Clonidine. What action should the nurse identify as the priority?

• A. Administer the Clonidine as prescribed.
• B. Provide ice chips to the patient.
• C. Educate the patient on Clonidine's effects.
• D. Obtain baseline vital signs.

Correct answer: D

Rationale: In this scenario, the priority action for the nurse is to obtain baseline vital signs. This is essential for establishing a baseline assessment, especially for a patient undergoing opioid withdrawal and starting a new medication like Clonidine. Monitoring vital signs is crucial for evaluating the patient's response to treatment and detecting any potential complications early on. Administering the medication, providing ice chips, and educating the patient on Clonidine's effects are important tasks but obtaining baseline vital signs takes precedence to ensure the patient's safety and proper management.

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