Nursing Elites

1. A patient has been taking hydrocodone, an opioid analgesic for their moderate pain, and they have taken more than the prescribed dose. What should you administer as the antidote if they experience toxicity?

• A. Naloxone
• B. N-acetylcysteine
• C. Atropine
• D. Digoxin immune Fab

Correct answer: A

Rationale: Naloxone is the specific antidote for opioid toxicity. It works by blocking the effects of opioids on the central nervous system, thereby reversing symptoms like respiratory depression and sedation. N-acetylcysteine is used for acetaminophen overdose, while atropine is indicated for certain types of poisonings. Digoxin immune Fab is used for digoxin toxicity. Therefore, in the case of opioid toxicity due to hydrocodone overdose, naloxone is the appropriate antidote.

2. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.

3. A client has a new prescription for Furosemide. Which of the following dietary instructions should the nurse provide?

• A. Increase your intake of bananas and oranges.
• B. Limit your intake of calcium-rich foods.
• C. Avoid drinking milk.
• D. Increase your intake of green, leafy vegetables.

Correct answer: A

Rationale: The correct answer is A: 'Increase your intake of bananas and oranges.' Furosemide, a loop diuretic, can cause potassium loss leading to hypokalemia. To prevent this, clients should increase their intake of potassium-rich foods, such as bananas and oranges, to replenish potassium levels. Choices B, C, and D are incorrect because limiting calcium-rich foods or avoiding milk is not necessary with Furosemide, and increasing intake of green, leafy vegetables does not specifically address the potential potassium loss associated with this medication.

4. A client has a prescription for hydrochlorothiazide to treat hypertension. The nurse should monitor the client for which of the following adverse effects?

• A. Hypokalemia
• B. Hypertension
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: Hydrochlorothiazide is a diuretic that can cause potassium loss, leading to hypokalemia. Monitoring potassium levels is crucial to prevent potential adverse effects such as cardiac arrhythmias and muscle weakness.

5. A client has a new prescription for nitroglycerin. Which of the following adverse effects should the nurse instruct the client to report that can indicate the medication is effective?

• A. Headache
• B. Nausea
• C. Dizziness
• D. Dry mouth

Correct answer: A

Rationale: Headache is a common side effect of nitroglycerin due to its vasodilatory effects. It can indicate that the medication is working effectively by dilating blood vessels, improving blood flow, and reducing cardiac workload. Therefore, the client should report experiencing headaches as it may suggest the therapeutic action of nitroglycerin. Nausea, dizziness, and dry mouth are not typically associated with the therapeutic effects of nitroglycerin and should be reported as adverse effects that may necessitate medical attention.

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