Nursing Elites

1. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.

2. A nurse is teaching a client who has a new prescription for Spironolactone. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, so the nurse should monitor the client for hyperkalemia, which can cause muscle weakness and cardiac dysrhythmias.

3. What information should you provide to your patient if they are taking sennosides? Select All That Apply.

• A. Sennosides should be used for short-term therapy
• B. The medication does not cure hypothyroidism
• C. The color of the urine may change to pink, red, violet, yellow, or brown
• D. Make sure to use other forms of bowel regulation

Correct answer: A

Rationale: When educating a patient taking sennosides, it is important to emphasize that these laxatives should be used for short-term therapy only. The medication does not address hypothyroidism, so this information is not relevant. Patients should be informed that the color of their urine may change to various colors like pink, red, violet, yellow, or brown, which is a common side effect of sennosides. It is advisable to incorporate other forms of bowel regulation alongside sennosides for optimal bowel health. Choice A is correct as it provides essential guidance on the duration of sennosides use. Choice B is incorrect because sennosides are not used to cure hypothyroidism. Choice C is correct as it highlights a common side effect of sennosides. Choice D is incorrect because it does not specifically relate to sennosides but rather suggests using other forms of bowel regulation in general.

4. A healthcare professional is preparing to administer a transfusion of 300 mL of pooled platelets for a client with severe Thrombocytopenia. How should the healthcare professional plan to administer the transfusion over which of the following time frames?

• A. Within 30 minutes/unit
• B. Within 60 minutes/unit
• C. Within 2 hours/unit
• D. Within 4 hours/unit

Correct answer: A

Rationale: Platelets are fragile components that must be administered promptly to minimize the risk of clumping. The correct administration time for platelets is within 15 to 30 minutes per unit to maintain their therapeutic effectiveness and reduce adverse effects. Administering platelets over longer time frames can lead to decreased efficacy and potential harm to the patient. Therefore, the correct answer is to administer the 300 mL of pooled platelets within 30 minutes per unit.

5. When a client is starting long-term oral prednisone for chronic asthma, what adverse effect should the nurse instruct the client to monitor for?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is a common adverse effect of oral prednisone due to sodium and water retention, which can lead to fluid retention. Monitoring weight changes is important as it helps in early identification of this adverse effect, enabling timely interventions to manage it. Choice B, nervousness, is not typically associated with oral prednisone use. Bradycardia (Choice C) is unlikely as prednisone usually causes tachycardia or increased heart rate. Constipation (Choice D) is not a common adverse effect of prednisone compared to weight gain.

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